Author: Freakonomics Radio

  • 593. You Can Make a Killing, but Not a Living

    AI transcript
    0:00:00 (dramatic music)
    0:00:02 Last week on the show,
    0:00:06 we told you about an unusual new play on Broadway
    0:00:09 called Stereophonic.
    0:00:11 It is a long, intimate, funny, and totally gripping show
    0:00:16 about a co-ed rock band in the 1970s
    0:00:19 as they record an album that will turn out to be a huge hit.
    0:00:23 Stereophonic itself has turned out to be a huge hit.
    0:00:26 If you watched the Tony Awards the other night,
    0:00:28 you saw superstars like Alicia Keys and Jay-Z,
    0:00:31 Daniel Radcliffe, even Hilary Clinton,
    0:00:34 who co-produced a Broadway musical this season.
    0:00:36 But it was Stereophonic,
    0:00:38 the play with a bunch of nobodies,
    0:00:40 as one cast member said during the Tony Awards,
    0:00:43 that stole the show, winning five awards.
    0:00:46 Here is the playwright, David Ajmi,
    0:00:49 accepting his award for best play.
    0:00:52 – This was a very hard journey to get this play up here.
    0:00:56 Michael McKeel and Fran Offenhauser,
    0:00:59 who gave me a place to live for seven years
    0:01:01 so that I could write this play.
    0:01:03 It’s really hard to make a career in the arts.
    0:01:06 We need to fund the arts in America.
    0:01:08 It is the hallmark of a civilized society.
    0:01:10 – When I interviewed Ajmi a couple of weeks ago,
    0:01:15 I asked him what it’s like to be at the vortex
    0:01:18 of a huge hit.
    0:01:19 He has been writing plays for a couple of decades,
    0:01:22 but this is his first show on Broadway.
    0:01:25 Here’s what he told us.
    0:01:26 – I feel like I’ve been in a car accident.
    0:01:27 We all feel that way.
    0:01:28 We’re just totally dislocated.
    0:01:30 It doesn’t feel good.
    0:01:31 It feels weirdly bad.
    0:01:33 – I have a little bit of a hard time believing that.
    0:01:35 – No, I know.
    0:01:36 Everyone does.
    0:01:37 Because you can’t take in what’s good or bad.
    0:01:40 You’re just taking in stimuli.
    0:01:41 You’re taking in the overstimulation,
    0:01:43 which you can’t take in because it exceeds your capacity.
    0:01:46 I know it’s positive intellectually,
    0:01:48 but the way I’m processing it isn’t like joyous.
    0:01:52 There’s moments of joy,
    0:01:53 and then we just get dislocated again,
    0:01:55 because we don’t know what’s happening.
    0:01:56 It’s too weird.
    0:01:58 When your status changes,
    0:01:59 everyone starts to act really weird.
    0:02:02 I don’t like it.
    0:02:04 – Maybe David Ajmi is just an unusual person,
    0:02:07 or maybe the people who create theater
    0:02:11 are an unusual people tuned to a different frequency.
    0:02:16 Why else would someone try to make a living
    0:02:18 in an industry that is so financially precarious,
    0:02:21 even in the best of times?
    0:02:23 And these have not been the best of times.
    0:02:26 – I’d say our costs have gone up about 30%
    0:02:29 since the pandemic.
    0:02:30 – So today on Freakinomics Radio,
    0:02:32 will the success of Stereophonic
    0:02:35 help change this grim future?
    0:02:37 – It’s not that we’re waiting for the audiences to come back.
    0:02:40 It’s that the core audience entirely has shifted.
    0:02:44 – Also, when you have a hot show,
    0:02:47 how do you think about raising ticket prices?
    0:02:50 – You kind of play a game of chicken with yourself
    0:02:52 and with your audience.
    0:02:54 – And we will give you some backstage gossip too.
    0:02:57 – I don’t know if I’m allowed to say this.
    0:03:00 – Yes, you’re allowed.
    0:03:01 We’ll hear all that starting now.
    0:03:03 (upbeat music)
    0:03:10 – This is Freakinomics Radio,
    0:03:19 the podcast that explores the hidden side of everything
    0:03:22 with your host, Stephen Dubner.
    0:03:24 (upbeat music)
    0:03:27 – As I mentioned in our previous episode,
    0:03:35 this two-part look at Stereophonic,
    0:03:38 spun out of another series that we’re making
    0:03:40 about the economics of live theater.
    0:03:43 The fundamental problem here is that theater
    0:03:45 is a handmade thing,
    0:03:47 and it doesn’t get much more efficient
    0:03:49 even as you add technology the way most industries do.
    0:03:52 Stereophonic is a relatively small show
    0:03:55 with just seven on-stage performers,
    0:03:57 but they sit atop a pyramid of dozens of people
    0:04:01 who help put on the show every night.
    0:04:03 Stage managers, wardrobe and props managers,
    0:04:06 lighting and sound technicians,
    0:04:08 the ushers in the theater,
    0:04:11 you even have to pay understudies,
    0:04:13 actors on standby in case anyone from the cast gets sick.
    0:04:17 It would be one thing if you could scale up a show
    0:04:20 that becomes a hit,
    0:04:21 if you could sell five or 10,000 tickets a night
    0:04:25 rather than the 770 that can fit into the Golden Theater
    0:04:30 where Stereophonic is playing.
    0:04:32 The show is seen by roughly 6,000 people every week.
    0:04:36 David Ajmi, who wrote Stereophonic,
    0:04:39 he is not one of those 6,000.
    0:04:42 – Oh, I don’t want you.
    0:04:43 I don’t see my shows
    0:04:44 because I can’t stand watching my own show
    0:04:46 in front of an audience.
    0:04:48 Sometimes I’ll have my assistant go as me,
    0:04:50 so I teach my assistant everything that I’m looking for
    0:04:53 and all my sticking points.
    0:04:55 And then I say, okay, did that happen?
    0:04:57 Did that happen?
    0:04:58 Did that happen?
    0:04:59 But I don’t like to watch it because I find it
    0:05:01 too intimate and excruciating.
    0:05:03 – Is it excruciating because it’s a thing that you made
    0:05:05 or it’s excruciating because it’s a thing that you made
    0:05:08 that is you essentially?
    0:05:09 – Both, but more the latter.
    0:05:11 And it’s excruciating because it’s live
    0:05:13 and I can’t control it.
    0:05:14 But it’s me also.
    0:05:16 It is the most vulnerable thing in the world.
    0:05:17 I can’t even tell you.
    0:05:18 – So if David Ajmi isn’t in the audience, who is?
    0:05:26 On Broadway right now, there are 35 shows running.
    0:05:30 Last week, they collectively sold 300,000 tickets.
    0:05:34 Who are those people?
    0:05:35 Let’s ask someone who knows.
    0:05:37 – My name is John Johnson.
    0:05:39 I run a production company called Wagner Johnson Productions
    0:05:42 that is a producing company as well
    0:05:43 as a general management company.
    0:05:45 – Johnson is one of the lead producers on Stereophonic.
    0:05:49 I asked him, who is coming to the theater post pandemic?
    0:05:52 – There used to be, and we used to call them
    0:05:54 carriage trade audiences that came from the Upper West Side
    0:05:59 and Upper East Side that were women of a certain age
    0:06:01 who would come down and see the new play
    0:06:04 from the National Theater or oh, Glenda Jackson’s in a play.
    0:06:08 I’m going to see that.
    0:06:09 – But now?
    0:06:10 – A new core audience has emerged in this season.
    0:06:14 It was emerging as we’ve gone through
    0:06:15 each season sequentially post pandemic.
    0:06:17 This season is the season of oh,
    0:06:20 it’s not that we’re waiting for the audiences to come back.
    0:06:23 It’s that the core audience entirely has shifted
    0:06:26 because we do have many more successes
    0:06:29 in season three post pandemic than we did the last two.
    0:06:33 – Name some of those successes
    0:06:34 in addition to Stereophonic.
    0:06:36 You have Gutenberg, the musical,
    0:06:38 which recouped in the fall.
    0:06:39 You have the production of “O’ Mary”
    0:06:41 that was a huge hit off Broadway that then transferred.
    0:06:44 We were producers, lead producers on “Danny and the Deplusee”
    0:06:46 off Broadway that starred Aubrey Plaza.
    0:06:49 That was a similar sort of success story.
    0:06:51 And then further on Broadway, we’re seeing, you know,
    0:06:54 Jeremy Strong, “An Enemy of the People,”
    0:06:56 Sarah Paulson, “Inappropriate.”
    0:06:57 Some would say, oh, well, Jeremy Strong was on succession.
    0:07:00 Of course, it’s going to be a massive sellout.
    0:07:02 Sarah Paulson is a star as well,
    0:07:05 but this isn’t Daniel Craig,
    0:07:06 who I’ve been fortunate enough to work with.
    0:07:08 It’s not folks that are global superstars.
    0:07:11 If the core audience pre-pandemic
    0:07:13 was women ages late 50s into their 70s,
    0:07:17 that we’re seeing shows six, eight times a year,
    0:07:19 that audience has shifted down dramatically
    0:07:22 to folks in their late 30s to their early 50s
    0:07:24 who have binged every season of “American Horror Story”
    0:07:27 that Sarah Paulson’s in.
    0:07:28 And now when she’s in a play, they’re going,
    0:07:30 oh, she’s on stage now, I’m going.
    0:07:32 The folks who binged succession four times over
    0:07:35 are sitting there going, Jeremy Strong’s in a play,
    0:07:37 I’m going to that.
    0:07:38 I don’t care how much it costs.
    0:07:39 It’s event theater.
    0:07:40 Event theater has always been there,
    0:07:41 but I think the nature of who is part of that event theater
    0:07:45 now has shifted a little bit.
    0:07:46 – The other thing I noticed about the stereophonic audience,
    0:07:49 it was the first play I’ve ever been to on Broadway,
    0:07:51 play or musical, where the restroom line for the men’s
    0:07:55 was longer than the women’s at intermission.
    0:07:57 – Did you see “Lemon Trilogy” two years ago?
    0:07:59 ‘Cause it was the same way at “Lemon Trilogy.”
    0:08:01 – I did not.
    0:08:02 – I agree, stereophonic fits into that same generational shifts
    0:08:05 as well in terms of the new core audience,
    0:08:06 because one would think, oh, it’s a story about a band
    0:08:09 in the late ’70s, it’s dead aimed towards a boomer audience.
    0:08:13 Don’t get me wrong, it’s not that we don’t have folks
    0:08:15 who are in that generation who’d come and see it,
    0:08:18 but the groundswell of support, the age range of it,
    0:08:21 you would think, oh, how is Gen Z going to tip into a play
    0:08:24 like this when most of these folks were born
    0:08:26 even 20 years after the play?
    0:08:28 But I think the nature of rock and roll,
    0:08:31 the nature of creating music,
    0:08:33 the nature of this bubble of a studio,
    0:08:36 and the drama that that creates is timeless.
    0:08:39 – I think the reason why, especially a lot of young people
    0:08:45 are coming to the theater in 2024,
    0:08:48 is that we forget, because I think we have collective PTSD,
    0:08:52 but we were locked in our houses for three and a half years.
    0:08:55 I think people want to be around each other.
    0:08:58 – That is Tom Pesinka, the actor who plays Peter,
    0:09:01 the leader of the band in Stereophonic.
    0:09:03 The band is never named,
    0:09:05 but they do bear a firm resemblance to Fleetwood Mac.
    0:09:08 Peter and his girlfriend, Diana,
    0:09:10 are at the center of a lot of the show’s drama.
    0:09:13 The entire cast has remained intact
    0:09:16 since the show began last year Off-Broadway
    0:09:18 at the non-profit theater Playwrights Horizons.
    0:09:21 – Off-Broadway, it felt very fake until you make it.
    0:09:25 You have to construct intimacy.
    0:09:28 You have to construct chemistry.
    0:09:31 I always say that on Broadway,
    0:09:33 if you had seen it off-Broadway,
    0:09:35 I think you’re gonna see a much tighter knit group.
    0:09:38 Sarah and I, we didn’t know each other at all.
    0:09:41 – I’m Sarah Pigeon,
    0:09:44 and I’m currently in Stereophonic playing Diana.
    0:09:47 We’ve done 50 performances,
    0:09:50 and we got previews close to 70.
    0:09:52 We did 70-something performances at Playwrights,
    0:09:55 and 20-something previews.
    0:09:57 No one’s taken the show off yet.
    0:09:59 – Are you kidding?
    0:10:00 – Not at all.
    0:10:01 At Playwrights, we canceled the first preview
    0:10:05 because I got sick,
    0:10:07 and then we canceled the fourth to last show
    0:10:10 because someone lost their voice.
    0:10:12 So we’ve only missed two.
    0:10:15 There’s sort of been this agreement
    0:10:16 that unless you’re deathly ill, you’ll be on the stage.
    0:10:19 – So you have a bunch of pissed-off understudies.
    0:10:21 (laughing)
    0:10:24 – I don’t know, you’d have to interview them.
    0:10:26 (gentle music)
    0:10:27 – I mean, I think it just requires
    0:10:29 a different type of stamina.
    0:10:31 – Live theater has been declared dead
    0:10:33 or dying for years.
    0:10:35 We have TV and film,
    0:10:36 and now we have an endless stream of entertainments
    0:10:40 and distractions,
    0:10:41 most of which require much less effort
    0:10:44 and coordination and investment than live theater.
    0:10:47 So what would be lost if live theater did disappear?
    0:10:52 – I think a certain level of discipline,
    0:10:56 a certain level of technique,
    0:10:57 a certain level of lineage would be lost.
    0:11:02 Working as an actor in the theater,
    0:11:05 it requires different muscles
    0:11:06 than working in television and film.
    0:11:09 You have to do eight shows a week.
    0:11:10 It’s the first time I’m really doing that,
    0:11:12 and my body’s breaking down.
    0:11:15 That’s just not what happens
    0:11:18 when you work in front of a camera.
    0:11:20 You get to go nap in your trailer for four hours
    0:11:22 until they call you to set,
    0:11:23 and you’re there for less than an hour,
    0:11:25 and you shoot four or five takes,
    0:11:27 and then you’re done.
    0:11:28 – In this job and how taxing it can be,
    0:11:31 eight shows a week,
    0:11:32 and then our show comes in a little over three hours,
    0:11:35 and there’s singing involved,
    0:11:38 and screaming, and laughing, and smoking,
    0:11:41 and I don’t have much of a life.
    0:11:43 I have no existence really
    0:11:45 outside of the Golden Theater on 45th Street.
    0:11:48 – Your off day is Monday?
    0:11:50 – Monday.
    0:11:51 – You have a Sunday matinee
    0:11:52 than no Sunday night show, is that right?
    0:11:54 – No Sunday night show.
    0:11:55 – So what do you do between the time
    0:11:56 you’re done Sunday afternoon
    0:11:58 and then Tuesday evening show?
    0:12:00 – I beat feet out of midtown.
    0:12:04 Sometimes my mom comes into town,
    0:12:06 and we get a nice dinner somewhere,
    0:12:09 and I sort of blow off some steam.
    0:12:11 There’s just no time to do that
    0:12:12 when you get home at 11 o’clock,
    0:12:13 like who wants to have dinner close to midnight,
    0:12:16 and then Monday is spent sleeping.
    0:12:19 I haven’t done laundry in a really long time.
    0:12:21 – Do you eat healthy?
    0:12:23 – I love food.
    0:12:25 I like healthy food,
    0:12:27 but recently, because of the schedule,
    0:12:30 I just find it quite difficult to find something
    0:12:32 that I want to eat before a three hour show,
    0:12:35 and sometimes two, three hour shows.
    0:12:37 So I’ve been getting these craft,
    0:12:39 mac and cheese, microwaveable, individual bowls,
    0:12:43 and they usually, I’m not looking at the microwave,
    0:12:45 so they spill all over the microwave,
    0:12:47 then I have to clean the microwave,
    0:12:49 but it is like carbs and a couple hundred calories
    0:12:53 to get you through the show
    0:12:54 and not have this huge, full stomach.
    0:12:56 I’ve ordered a lot of different types of soups
    0:13:01 during this run,
    0:13:03 because sometimes my voice is a little rough.
    0:13:06 ♪ Sunday morning ♪
    0:13:11 ♪ And the life’s fine ♪
    0:13:15 – Sarah Pigeon and Tom Pesinka
    0:13:17 were both nominated for Tony Awards,
    0:13:20 but neither of them won.
    0:13:22 Stereophonic did win Best New Play, Best Direction,
    0:13:25 Best Scenic Design, and Sound Design,
    0:13:28 and Will Brill, who plays the band’s bassist, Reg,
    0:13:32 won Best Featured Actor in a Play.
    0:13:35 It was Brill who, during his acceptance speech,
    0:13:38 called the Stereophonic crew a bunch of nobodies.
    0:13:41 – I think awards are really important for the artists.
    0:13:46 I find them quite stressful,
    0:13:47 and I find them quite difficult,
    0:13:49 because there are always thousands of people
    0:13:53 who’ve worked so hard and they are not recognized.
    0:13:56 – That is Sonia Friedman.
    0:13:58 She is another lead producer of Stereophonic,
    0:14:01 and she is one of the most successful
    0:14:03 theatrical producers in the world.
    0:14:05 – I watch these artists work really, really hard
    0:14:09 and try to find the beauty in what they’re doing,
    0:14:14 but they aren’t always kind to themselves in the process.
    0:14:19 We’re in a very, very, very difficult world,
    0:14:21 and what Stereophonic, if nothing else, reminds me
    0:14:26 is that whilst we’re making art,
    0:14:28 we must also do everything we can
    0:14:31 to be kind to one another.
    0:14:33 – Is Stereophonic, to some degree, a metaphor
    0:14:35 for what you and your colleagues do all day, every day?
    0:14:38 I mean, one great thing about the theater
    0:14:41 or any of the performing arts,
    0:14:44 but that is also a challenge,
    0:14:45 is you need to do it live and do it well
    0:14:48 every time because last night’s performance
    0:14:52 might’ve been great,
    0:14:53 but that’s not what tonight’s audience is seeing.
    0:14:56 – I think what it is is just very honest
    0:14:58 about how we make work,
    0:15:01 and that what an audience will see
    0:15:04 isn’t always the mechanics of how messy it can be
    0:15:08 and how relationships can be really, really fractious,
    0:15:13 offstage, and then they come onstage
    0:15:15 and nobody would ever know.
    0:15:16 I could tell you so many secrets
    0:15:18 about chaotic relationships that happen in the wings
    0:15:21 and then they come onstage.
    0:15:23 – Well, let’s have a couple.
    0:15:24 – And now I’m not gonna give you any,
    0:15:25 but that’s the illusion of theater
    0:15:27 and that’s the magic of theater.
    0:15:29 There’s this invisible magic line
    0:15:31 between the wings and on the stage,
    0:15:33 and they are two completely separate worlds.
    0:15:36 You step over that line
    0:15:38 and that’s where the magic happens right in front of you,
    0:15:42 and then you step behind that line
    0:15:44 and it’s not always as magic.
    0:15:46 – After the break, we step behind that line.
    0:15:52 I’m Stephen Dubner and this is Freakin’ Omics Radio.
    0:15:55 Sonia Friedman has been producing theater
    0:16:08 in London, New York, and elsewhere
    0:16:10 for more than 30 years.
    0:16:12 Her shows have won dozens upon dozens of major awards.
    0:16:16 The other night, her shows won nine Tony Awards,
    0:16:20 five for Stereophonic and four for the revival
    0:16:23 of Stephen Sondheim’s Merrily We Roll Along.
    0:16:26 She’s had several other shows on Broadway this season,
    0:16:29 including a new drama called Patriots
    0:16:31 about the rise of Vladimir Putin.
    0:16:34 She has also produced the long-running Harry Potter
    0:16:36 and the Cursed Child
    0:16:38 and the very long-running Book of Mormon.
    0:16:41 Normally I’m producing upwards of 12, 15 shows
    0:16:44 across the world.
    0:16:46 – And what is Friedman’s advice for a would-be producer?
    0:16:49 – You should be as a producer,
    0:16:51 as interested in the business side of it.
    0:16:54 One of the reasons why I’ve had longevity in the industry
    0:16:56 is that I’m as fascinated and interested
    0:17:00 with the numbers.
    0:17:02 I will do all my own budgets.
    0:17:03 Before I set out to do a show,
    0:17:05 I’ll be the one that sits behind a computer
    0:17:07 and literally batches it out.
    0:17:09 I need to understand where the show needs to sit
    0:17:12 in terms of what’s scale theater
    0:17:14 and what the whole model of it needs to be
    0:17:18 in order to make it viable.
    0:17:20 – Does it happen now and again
    0:17:21 that there’s a show that you’re dying to produce
    0:17:23 but you just can’t make it work financially
    0:17:25 in the theaters that are available to you?
    0:17:27 – Yes.
    0:17:28 – How often?
    0:17:28 – It’s becoming more often now
    0:17:30 because everything is getting more expensive.
    0:17:34 – In London, as in New York.
    0:17:35 London is still a better economic model than New York
    0:17:40 but we’re creeping up.
    0:17:42 I mean, we’ve gone up 21% our costs since COVID.
    0:17:45 – But New York’s probably 40 or something.
    0:17:48 – New York is about,
    0:17:51 it’s hard to put an actual figure on it
    0:17:52 but I’d say our costs have gone up about 30%
    0:17:55 since the pandemic.
    0:17:56 – And why is London’s economic model
    0:17:59 for theater better than New York’s?
    0:18:01 – When I first started producing in New York,
    0:18:03 taking into account the exchange rate,
    0:18:05 New York was about three times more expensive than London
    0:18:08 and it’s now about five times.
    0:18:10 The play that would cost me 1.5 million in London
    0:18:14 will now have to be capitalized
    0:18:16 between seven and eight million in New York.
    0:18:19 And because of the week pound,
    0:18:22 that’s really, really expensive for us.
    0:18:25 And the difference, why?
    0:18:27 – I mean, it sounds implausible for two things
    0:18:30 that are so similar in such seemingly similar places
    0:18:34 to be so…
    0:18:36 – It does, it does
    0:18:36 because it’s exactly the same show.
    0:18:39 It’s the same set, same group of actors on the stage.
    0:18:42 – So what’s driving it?
    0:18:43 – Absolutely everything is more expensive over here.
    0:18:47 – What’s the biggest difference?
    0:18:48 Is it the real estate, the renting of the theater?
    0:18:51 – The unions, number one, look, I’m not anti-union,
    0:18:54 that’s just a fact.
    0:18:55 – How many unions would be typically involved
    0:18:57 in a Broadway show?
    0:18:58 – I’m gonna say a number
    0:18:59 and then I might have to come back and correct it.
    0:19:03 – I think it’s about 17 unions.
    0:19:06 – There are actually 13 unions.
    0:19:08 For instance, IOTC Local 751,
    0:19:11 which represents box office treasurers
    0:19:14 and theatrical wardrobe union Local 764,
    0:19:18 which represents wardrobe workers
    0:19:20 and the guardians who supervise child actors.
    0:19:23 – So that’s the unions, yes, the real estate,
    0:19:26 it is more expensive here, it just is.
    0:19:29 The advertising is very, very expensive.
    0:19:32 The shops that build the sets
    0:19:34 have become much more expensive since COVID
    0:19:37 because of the supply chain issue.
    0:19:39 Highers of lighting, sound, all of the video equipment,
    0:19:43 the deals for the star actors,
    0:19:45 they know their power, they know their worth.
    0:19:47 Everything is more expensive
    0:19:50 and it’s much, much harder therefore
    0:19:53 to take creative risk here in New York,
    0:19:56 and which is why Stereophonic is beautiful and wonderful,
    0:19:59 but it’s an outlier.
    0:20:01 It’s not the norm.
    0:20:02 – Do you think it bodes well for the future?
    0:20:06 – Look, I think every season you have to have
    0:20:09 something like Stereophonic,
    0:20:10 where you can prove that you can do shows on Broadway
    0:20:15 and they can have a financial model
    0:20:19 that can withstand the costs of New York.
    0:20:24 – So how do you withstand the costs of New York?
    0:20:29 – By selling as many tickets as you can
    0:20:31 at as high a price as the market will allow.
    0:20:35 The average price of a Broadway ticket is around $125,
    0:20:39 but premium seats can sell for multiples of that.
    0:20:42 And it’s up to people like John Johnson
    0:20:44 to set those prices.
    0:20:46 – There’s definitely a little bit of feel to it
    0:20:48 as opposed to the ticketing companies
    0:20:50 for concerts or sporting events in terms of the algorithm,
    0:20:53 but that’s because they’re dealing with 25,000 seats
    0:20:56 in an arena or 50,000 seats in a baseball stadium
    0:20:59 or 80,000 seats in a football stadium.
    0:21:01 Here, we have 800 seats a night
    0:21:03 or in terms of Stereophonic specifically,
    0:21:05 770 seats a night.
    0:21:07 – And I guess it’s always tricky
    0:21:08 when you’re selling an asset that’s so perishable.
    0:21:11 – For sure.
    0:21:12 We will have premium pricing now that ranges anywhere
    0:21:14 from $249 on a Wednesday matinee
    0:21:17 all the way to $349 on a Friday or Saturday night.
    0:21:21 – So Stereophonic grossed nearly $800,000 last week,
    0:21:24 which is a really good number,
    0:21:26 but it’s still not nearly among the leaders in grossing.
    0:21:31 – Correct.
    0:21:32 – I’m sure some of that is size of house.
    0:21:34 Maybe some of it is ticket price.
    0:21:35 I don’t know.
    0:21:36 How do you look at this as an asset
    0:21:38 that you’re trying to properly price
    0:21:40 and extract the right amount of return on?
    0:21:43 – We priced the show to move early on
    0:21:46 because we knew that while it was a white hot ticket
    0:21:48 at Playwrights Horizons,
    0:21:50 the only way that we can get it back
    0:21:51 is that if the houses are full,
    0:21:53 that the word of mouth can continue to spread
    0:21:55 and how do we jumpstart that?
    0:21:56 And we jumpstart that by saying,
    0:21:58 we’re just gonna price the show to move.
    0:22:00 We had preview pricing that was $40, $80, $120 to start
    0:22:04 for the month of April,
    0:22:06 but you have to catch up to it
    0:22:07 because now we can get $229 for them.
    0:22:12 You kind of play a game of chicken with yourself
    0:22:14 and with your audience for something like Stereophonic
    0:22:17 because it’s an unknown title.
    0:22:20 Obviously it’s getting more well-known,
    0:22:21 but two, it does not have a major mega star in it.
    0:22:24 It has a group of incredible rising stars,
    0:22:27 but they’re not household names.
    0:22:29 The way that we get there is by getting people in the door
    0:22:33 and really building to that moment.
    0:22:35 Additionally, we have about 30 to 50 Tony voters
    0:22:38 in the show each night and those are comp tickets.
    0:22:41 We have tons of press who also are seeing the show for free
    0:22:44 for that New York Times feature that’s coming
    0:22:46 or that TV Booker for Live with Kelly and Mark
    0:22:50 or Jimmy Fallon.
    0:22:51 – Or that pesky podcast.
    0:22:53 – Or that pesky podcast exactly.
    0:22:54 – How often do you reevaluate your ticket pricing
    0:22:58 and strategies at a daily thing, a weekly thing?
    0:23:00 – I would say a couple of times a week.
    0:23:02 You see how the show sells, you see where it goes.
    0:23:05 We’re not going so out of control
    0:23:08 of sitting there on a Sunday morning,
    0:23:10 pulling levers and twisting knobs there.
    0:23:11 It’s usually like a Monday, Wednesday, Friday type thing.
    0:23:14 – So Stereophonic was originally booked into the Golden Theater
    0:23:18 for a relatively short run,
    0:23:19 but you’ve already extended that a couple of times.
    0:23:21 Now at least until early 2025,
    0:23:25 could you envision this show playing on Broadway
    0:23:28 for years and years?
    0:23:30 – I mean, in my wildest dreams, sure.
    0:23:32 The surprises are what keeps every person
    0:23:35 that you probably talk to on this podcast coming back
    0:23:37 because as much as yes, it’s hard and yes, it’s expensive.
    0:23:41 When something like that hits, it makes everyone just go, yes.
    0:23:46 This is why we do what we do.
    0:23:48 We just keep saying over and over again,
    0:23:50 when will it slow down?
    0:23:51 When will the sales slow down?
    0:23:52 When will it sort of stop?
    0:23:54 And it just has not yet.
    0:23:55 We are going to scale.
    0:23:56 We’re going to have a London production.
    0:23:57 We’re going to have a first-class national tour, et cetera.
    0:24:00 – There’s going to be a film, I understand.
    0:24:02 – There’s lots of interest in the film.
    0:24:04 – And would an initial investment
    0:24:06 in the theatrical production get me a piece of that or no?
    0:24:09 – Doesn’t get you the right to invest in it.
    0:24:11 They have the right, but not the obligation to invest in London.
    0:24:13 They have the right, but not the obligation
    0:24:14 to invest in the national tour,
    0:24:15 but there’s a firewall there for any movie.
    0:24:18 The standard number you see
    0:24:20 is that only around 20% of Broadway shows recoup
    0:24:23 even their original investment.
    0:24:25 Based on people I’ve been speaking with
    0:24:27 and based on some personal exposure,
    0:24:29 I wouldn’t be surprised if 20% is actually overstating it.
    0:24:33 But whatever the case,
    0:24:34 most Broadway shows lose a lot of money for their investors.
    0:24:37 Does it even make sense to call it investing?
    0:24:40 Should I think of it instead as essentially
    0:24:43 a way of supporting the arts with a small chance
    0:24:46 that I’ll actually get some money back?
    0:24:48 – Commercial philanthropy is what some people like to call it.
    0:24:51 – When I first heard that phrase or that idea,
    0:24:53 I thought, yeah, it’s unfortunately true,
    0:24:55 but then I think what’s unfortunate about it, right?
    0:24:57 I mean, people spend all kinds of money
    0:24:59 on all kinds of things.
    0:25:00 – Exactly.
    0:25:00 – It’s kind of like buying a lottery ticket, I guess,
    0:25:02 is the way I think of it now.
    0:25:03 – The odds are probably a little bit better
    0:25:05 than a lottery ticket.
    0:25:06 It’s on par with most restaurants.
    0:25:08 Let’s use a gambling analogy like a Blackjack table
    0:25:11 or, but I’ll use your lottery one as well.
    0:25:13 Hip begets more hits as it scales up.
    0:25:15 And so as you’re coming back to buy that lottery ticket,
    0:25:19 your odds of winning again are pretty impossible.
    0:25:21 If you have a good run at a Blackjack table
    0:25:22 and then you go back the next day,
    0:25:23 be like, I’m really good at Blackjack,
    0:25:24 but it’s like, no, you just went on a run.
    0:25:26 Whereas in the instance of any of these mega-hit musicals
    0:25:30 that then scale, you’re walking back to a table
    0:25:32 that you know you’re gonna be getting 21 over and over again,
    0:25:35 because as it scales, it’s gonna continue to do that.
    0:25:39 There are tons of cliche sayings in the theater.
    0:25:40 You know, you can make a killing or you can get killed.
    0:25:43 Anybody who was around in the 80s, like people would talk about,
    0:25:46 oh, my cat’s investment returned 5,000%.
    0:25:49 That makes the stock market or any hedge fund manager
    0:25:52 kind of, you know, blow their mind.
    0:25:53 So on the rare occasion that a show does return 5,000%,
    0:25:59 how is that money divvied up?
    0:26:01 For instance, do the non-household names in Stereophonic
    0:26:05 get any back end?
    0:26:07 We’ll find out after this break.
    0:26:08 I’m Stephen Dubner and this is Freakonomics Radio.
    0:26:12 [MUSIC PLAYING]
    0:26:15 The new hit Broadway play Stereophonic
    0:26:23 is about a band getting famous as they’re in the studio
    0:26:27 making their second record and how their relationships ebb
    0:26:30 and flow and sometimes crater as they are beset by the fame.
    0:26:36 That is very much the case for Diana and Peter,
    0:26:39 as played by Sarah Pigeon and Tom Pesinka.
    0:26:42 So many plays are described as like slice of life,
    0:26:45 but I think our play really is a slice of life.
    0:26:47 You’re coming into it in the middle of something
    0:26:50 and you’re leaving it in the middle of something.
    0:26:52 It’s more of a comma as opposed to a period.
    0:26:56 We know that these people will live on.
    0:26:58 We know that their careers will change or end or something.
    0:27:05 Where do you think Diana is five years after the play ends?
    0:27:10 I think she writes a solo album.
    0:27:12 I think it’s good, but I think she always feels like it would
    0:27:14 have been better if she did it with Peter.
    0:27:16 What’s Peter doing five years after?
    0:27:18 I don’t know if I’m allowed to say this.
    0:27:20 I think at one point it was said that Grover goes on
    0:27:25 to become one of the world’s greatest producers
    0:27:28 and Peter sleeps on his couch for a bit.
    0:27:32 At least the actor playing Peter won’t be sleeping
    0:27:35 on couches anytime soon.
    0:27:36 Tom Pesinka has been performing his whole life.
    0:27:40 He did musicals all through high school
    0:27:42 and eventually went to Yale drama school.
    0:27:44 He’s kept busy ever since.
    0:27:46 Some stage work, some TV and film,
    0:27:48 but career success has taken a while.
    0:27:52 Stereophonic is a big boost for him.
    0:27:56 I’m doing interviews for the first time.
    0:27:57 I’m doing photo shoots for the first time.
    0:27:59 I’m doing all this stuff.
    0:28:00 It’s so novel to me, everything.
    0:28:02 Is it everything I’ve ever wanted on paper?
    0:28:05 Yeah, for sure.
    0:28:06 But experiencing it is a very different story.
    0:28:10 We had a big press day when the Tony nominations came out.
    0:28:13 Just going from interview to interview to interview.
    0:28:16 I was so exhausted by the end of it
    0:28:18 and I went back to the hotel room
    0:28:19 where my girlfriend and my dog were staying.
    0:28:22 I just drew a circle with my finger in the air
    0:28:26 and I said, this is real life.
    0:28:28 That is something else.
    0:28:29 And I will participate in that for my business and it’s fun.
    0:28:33 But I’m so glad that this stuff
    0:28:35 is starting to happen for me at 36 and not 21
    0:28:39 ’cause I think it’s so easy to lose your head
    0:28:42 and blur the lines between what is real life
    0:28:46 and what is, I don’t know, something else.
    0:28:50 When real rock stars come to see the show,
    0:28:53 I know Ronnie Wood is coming soon
    0:28:55 or just came between Rolling Stones shows.
    0:28:58 Have you met with them afterwards?
    0:29:00 No, and this is like a PSA
    0:29:02 to all the famous people that come to the show.
    0:29:04 Please say hello.
    0:29:05 (laughing)
    0:29:06 No one comes back.
    0:29:08 I have a guest book
    0:29:09 and there’s one signature in it, Ellen Burston.
    0:29:11 She’s the only person in my guest book
    0:29:14 and I’d love to fill it up.
    0:29:15 As the producer John Johnson told us,
    0:29:18 neither Tom Pesinka nor any of the other cast members
    0:29:21 of Stereophonic are household names.
    0:29:24 Only one of them, Will Brill, had ever been in a Broadway show.
    0:29:29 But they are now responsible for helping create a hit
    0:29:32 that may earn its producers and investors a very good return.
    0:29:36 Traditionally, only big stars
    0:29:38 have had profit sharing deals on Broadway,
    0:29:40 but lately, thanks to the broader economic discussions
    0:29:43 around income inequality,
    0:29:45 there has been a movement toward broadening this practice.
    0:29:48 So I asked John Johnson if or how the cast members
    0:29:52 of Stereophonic may share in the show’s financial upside.
    0:29:57 Yeah, we structure a lot of our deals
    0:29:58 regardless of whether the person is a household name
    0:30:01 or not with an upside potential
    0:30:03 because I think in general,
    0:30:05 when everyone is along for the ride
    0:30:08 and everyone is cut in,
    0:30:10 it makes the experience for all sort of spiritually better.
    0:30:14 When you say upside potentially mean if the show does well,
    0:30:16 the performers start to get a piece of the action.
    0:30:19 Correct.
    0:30:20 The specific nature of the show being an ensemble piece
    0:30:23 and being this band, literally, who have grown together,
    0:30:27 it just felt right.
    0:30:29 I’ve done tons of shows that have had singular A-list stars
    0:30:33 that you pay a handsome amount of money
    0:30:36 and it’s a 14 or 16 week run
    0:30:37 ’cause that’s what stars like to do
    0:30:39 because then they’re off to their next TV show
    0:30:40 or their next movie.
    0:30:41 So I get paid 5,000 a week.
    0:30:45 That’s Tom Pesinka.
    0:30:47 But I see 2,000 something of that because of taxes
    0:30:51 and because of 20% goes to my representation.
    0:30:55 I’m also paying other people as well.
    0:30:58 I think people don’t realize on Broadway
    0:31:00 when you’re especially running a Tony campaign,
    0:31:02 you’re hiring a publicist.
    0:31:03 You are not the show.
    0:31:05 The show has a publicist,
    0:31:06 but I also elected to hire my personal publicist,
    0:31:10 a stylist, someone who grooms me.
    0:31:13 If it’s a Tony event and I’m a Tony nominee,
    0:31:15 the producers will give me a certain amount of money
    0:31:19 to spend on those things.
    0:31:20 But you’re still spending a lot out of pocket.
    0:31:22 Spending a lot of money.
    0:31:24 The profit sharing, I don’t know exactly what it is.
    0:31:28 Was it negotiated collectively with all of you?
    0:31:31 Yes, we negotiated collectively for everything.
    0:31:34 Was that a union driven negotiation or no?
    0:31:37 No, we got together as a cast.
    0:31:40 We put our points down.
    0:31:42 What was negotiable, what was non-negotiable?
    0:31:44 Then we went to our agents and managers with that,
    0:31:47 and then they got together collectively,
    0:31:49 and then they went to the producers.
    0:31:50 At what point was this?
    0:31:51 Was this before the transfer to Broadway?
    0:31:54 Yeah, this was when we were negotiating
    0:31:55 the Broadway contract.
    0:31:57 What were you getting paid at playwrights per week?
    0:31:59 1200, I think.
    0:32:01 So to some kid who’s listening to you and saying,
    0:32:05 “Oh, yeah, I’d like to have a hit like that
    0:32:07 and an interesting character like that and a life like that.”
    0:32:11 How would you advise them about the actual career prospects
    0:32:14 of paying rent and living and maybe having a family and so on?
    0:32:19 That’s something I’ve been thinking about a lot
    0:32:21 because my girlfriend and I were having those discussions.
    0:32:24 She’s getting to an age, I’m getting to an age
    0:32:27 where it’s like, okay, we live together.
    0:32:29 Are we gonna have a kid?
    0:32:30 Are we gonna get married?
    0:32:31 Like, what’s the deal?
    0:32:33 I want those things, for sure.
    0:32:35 But I gotta get a series.
    0:32:37 Even if you’re in a hit on Broadway, it’s hard.
    0:32:41 Unfortunately, if you just wanna be a theater artist,
    0:32:44 you have to live a certain lifestyle.
    0:32:47 I don’t wanna live that lifestyle.
    0:32:49 I wanna live a different lifestyle.
    0:32:52 I wanna have a house.
    0:32:53 I wanna be able to put my kids through college.
    0:32:55 I wanna be able to do all of that by my dog,
    0:32:58 really fancy dog food ’cause she’s really stingy
    0:33:00 about eating kibble.
    0:33:02 After this show, I wanna get like on a HBO series
    0:33:07 where I’m on 10 episodes or 13 episodes
    0:33:10 and I’m making tens of thousands of dollars per episode
    0:33:15 so I can afford the life that I’ve decided
    0:33:18 and I’m not ashamed of wanting.
    0:33:21 – Do you think most people who come to New York
    0:33:23 and buy one or two Broadway tickets,
    0:33:26 do you think they assume that the average performer
    0:33:30 is making a lot more money
    0:33:31 than the average performer actually is?
    0:33:33 – Probably.
    0:33:34 I also think it depends on who you are, right?
    0:33:36 I’ve heard crazy stories of Hugh Jackman making,
    0:33:39 I don’t know, a million dollars a week or something
    0:33:41 or getting a certain cut of the box office.
    0:33:44 I’m not ragging on Hugh Jackman, he’s great.
    0:33:46 But also again, lifestyle, he has a lifestyle
    0:33:49 and he can’t just take a year out of his life
    0:33:52 and do Broadway and not get paid a million dollars a week.
    0:33:54 – Hugh Jackman did recently star
    0:33:58 in a Broadway revival of The Music Man.
    0:34:01 For more than a year, he did eight shows a week.
    0:34:04 His salary was never made public
    0:34:06 but a million dollars a week would seem high
    0:34:09 industry people we’ve spoken with
    0:34:10 put the likely figure at around $300,000,
    0:34:14 although that was likely augmented
    0:34:16 by a share of the box office.
    0:34:18 But for most people working on Broadway,
    0:34:21 the economics are tough.
    0:34:23 I went back to stereophonic producer John Johnson.
    0:34:27 If you read the newspapers and even the trades
    0:34:31 about the economics of producing live theater these days,
    0:34:34 the last, let’s call it five years especially,
    0:34:37 it’s easy to come to the conclusion
    0:34:38 that live theater is basically dying.
    0:34:40 It’s too expensive to produce.
    0:34:42 The audiences are not the same or are not returning.
    0:34:45 There are too many countervailing forces.
    0:34:46 Unions have too much leverage.
    0:34:48 The theater owners have too much leverage.
    0:34:51 There are many, many, many other media options
    0:34:54 that audiences are taking advantage of.
    0:34:56 You sound, John, like the first person I’ve spoken with
    0:34:59 who doesn’t exude that kind of death rattle.
    0:35:04 – Yeah, it’s a little dramatic.
    0:35:05 When I started in the business,
    0:35:07 my first boss was a legendary producer
    0:35:08 by the name of Liz McCann.
    0:35:10 She had worked in the theater for almost 60 years.
    0:35:13 She used to talk about the late ’70s,
    0:35:15 the time period of which the same thing was being said.
    0:35:19 New York was told to drop dead.
    0:35:21 The Bronx was burning.
    0:35:22 Crime was up.
    0:35:23 The theaters were being torn down.
    0:35:25 That was a way worse time than what we’re talking about now.
    0:35:28 And yet at the same time,
    0:35:30 what came out of that afterwards was in the ’80s,
    0:35:33 a massive boom.
    0:35:34 It was the British invasion.
    0:35:36 It was Lloyd Webber.
    0:35:37 It was Cameron McIntosh coming in with these massive shows.
    0:35:40 That’s what came out of that period of the late ’70s.
    0:35:43 The other example I’d like to give is the financial crash.
    0:35:46 What we went through in late 2008, 2009, 2010,
    0:35:49 I think way worse than what we’re dealing with now
    0:35:52 from a standpoint of fundraising drying up,
    0:35:55 shows having to close prematurely.
    0:35:57 14 shows closed at the top of 2009 right after the crash.
    0:36:02 It was almost worse than the pandemic
    0:36:03 because everyone stayed home and saved money.
    0:36:06 Or at least now, what they want to see is different.
    0:36:09 But if they do really want to see something,
    0:36:12 whether it be Daniel Radcliffe and Mary Lou Roelong
    0:36:15 or Sarah Paulson or Jeremy Strong, they will pay for it.
    0:36:19 Is it challenging?
    0:36:20 Yes, are we dealing with costs going up?
    0:36:23 Yes, are we dealing with not being able to figure out
    0:36:27 how to get the audiences to the shows
    0:36:30 and how to entice them in a world
    0:36:32 where you can’t just take ads on television anymore
    0:36:35 because no one’s watching traditional television.
    0:36:38 How is Stereophonic being marketed
    0:36:41 and sold differently now than it might have been 20 years ago?
    0:36:45 Oh, it’s almost entirely all digital now.
    0:36:47 It’s all mobile.
    0:36:48 It’s all through Meta.
    0:36:49 It’s all through Instagram, Facebook.
    0:36:51 We do still take the traditional behavioral banner ads
    0:36:54 that follow you around the internet.
    0:36:56 We still do some prints, but not a ton.
    0:36:59 We have dabbled into television,
    0:37:00 but we’re taking specific ads.
    0:37:02 We’re not taking giant flights with, you know,
    0:37:05 multiple spots on Good Morning America to the Today Show,
    0:37:07 which was always your bread and butter.
    0:37:09 Because again, the audience that you were going for,
    0:37:12 that demographic that was coming six, eight times a year
    0:37:15 from the suburbs were the same folks who would, you know,
    0:37:18 get the kids off to school and then turn on the Today Show
    0:37:20 and watch the commercials kind of roll by and go,
    0:37:23 “Oh, that’s show. I’ve heard of that.
    0:37:24 I need to go see that.”
    0:37:25 Now it’s all in your hand.
    0:37:26 How do the costs of a digital first marketing
    0:37:29 and advertising campaign compare to the old school,
    0:37:32 and what’s the ROI compared to the old school?
    0:37:35 – The ROI is much easier to figure out
    0:37:38 because you can actually track people.
    0:37:41 Our zip code reporting has way more sophisticated
    0:37:44 now than it was before,
    0:37:45 whereas you had to blanket the market with something
    0:37:48 and then you didn’t see a direct correlation.
    0:37:51 Now it’s less things,
    0:37:54 but you can still see how your wraps jump
    0:37:57 due to specific things of press,
    0:37:58 like a CBS Sunday morning piece,
    0:38:00 or if your stars are on Morning Joe,
    0:38:03 there are fewer things that give you that pop,
    0:38:05 but at least you know if I’m on Morning Joe,
    0:38:07 then we’re going to have a good day at the box office.
    0:38:10 (upbeat music)
    0:38:12 – There are other ways in which the theater industry
    0:38:16 intersects with the larger entertainment ecosystem.
    0:38:19 Here again is the producer, Sonia Friedman.
    0:38:22 – If you look across Broadway
    0:38:24 and the West End over the last 50 years,
    0:38:27 a lot of the new shows have come from studios,
    0:38:31 Universal, Fox, MGM,
    0:38:33 and Netflix are going to be no different in that respect.
    0:38:37 – Friedman has already worked with Netflix twice.
    0:38:40 The first was turning a Netflix property,
    0:38:43 Stranger Things, into a live theatrical show in London.
    0:38:47 – With Stranger Things, actually we went to them.
    0:38:50 It was a very, very specific challenge
    0:38:53 about can you put sci-fi on stage?
    0:38:56 It’s a actually surprisingly emotional story
    0:38:59 about a little kid who’s metaphorically
    0:39:02 and literally got a monster growing inside of him,
    0:39:04 and how does he beat this monster?
    0:39:07 It’s a very, very simple yet universal tale we’re telling,
    0:39:10 but we also wanted to see whether we could go for it,
    0:39:13 technically, go for it in the most extraordinary way.
    0:39:17 Netflix loved the idea and they became our partner on it.
    0:39:21 – And theater for them is relatively cheap,
    0:39:24 I mean, considering their scale.
    0:39:25 – I would have thought so, but it’s all relative to me.
    0:39:29 When Stranger Things comes to Broadway,
    0:39:31 they will be our partners and I have to make sure
    0:39:34 that the financial model still makes sense.
    0:39:37 – So that’s one way for Netflix to be involved
    0:39:41 in live theater, but there is another way.
    0:39:45 Consider Sonia Friedman’s recent production
    0:39:47 of the play Patriots on Broadway.
    0:39:50 It was written for the stage by Peter Morgan,
    0:39:53 best known for creating the Netflix series,
    0:39:55 The Crown, and Netflix is a big investor
    0:39:59 in the Broadway show.
    0:40:00 – With Patriots, that was absolutely driven by Pete Morgan,
    0:40:04 and Netflix wanted to support the Patriots journey.
    0:40:08 I think they’re gonna make it into a film or something,
    0:40:10 but I can say no more beyond that.
    0:40:12 – Would you like to be involved in turning
    0:40:14 stereophonic into a film or series?
    0:40:16 – Of course, I think it would be a fantastic series.
    0:40:21 – I’ve heard a little talk about you producing
    0:40:23 more TV film.
    0:40:25 Would you like to be a full-blown producer in that realm?
    0:40:28 – I would do it, but I don’t want it to be what I do,
    0:40:31 because I love theater every single night.
    0:40:34 Who knows what’s gonna happen.
    0:40:36 Seeing the audience, just feeling and hearing.
    0:40:39 When I make TV, I’ve done a few.
    0:40:41 It’s really exciting, but then it’s done.
    0:40:44 It’s always slightly anticlimactic.
    0:40:47 When it comes out on telly and you go, oh, that’s it.
    0:40:51 You sit there at home on your own with a box of popcorn,
    0:40:56 and then you look at Twitter and go, okay, so that’s happened.
    0:40:59 Where’s the adrenaline?
    0:41:00 Where’s that extraordinary cortisol hit
    0:41:05 that you get with theater, which is you literally walk in,
    0:41:09 and my heart beats faster, and it’s terrifying,
    0:41:14 and it’s wonderful.
    0:41:15 I mean, particularly with shows
    0:41:16 which have a lot of technical challenges,
    0:41:18 is it gonna go wrong tonight?
    0:41:20 Are we gonna get through it?
    0:41:22 When I have nine, 10 shows running at any one time,
    0:41:25 I will not be able to go to sleep in London
    0:41:27 until the curtain’s at least gone up in New York,
    0:41:31 just so I know that’s happened.
    0:41:33 And then I’ll usually wake up in middle of the night
    0:41:36 just to check that they’ve gone okay.
    0:41:38 And that’s how I’ve lived my life for 20 years.
    0:41:41 And then we had the pandemic.
    0:41:43 And I think that everything came into stark relief
    0:41:47 as we all know for the world.
    0:41:48 – And you had just opened Leopoldstadt,
    0:41:51 the Tom Stoppard play in the West End.
    0:41:53 – Just opened Leopoldstadt
    0:41:54 exactly about three or four days beforehand.
    0:41:57 I had another 17 shows across the world.
    0:42:00 It was obviously sort of shocking.
    0:42:04 And frankly, as I talk about it now,
    0:42:06 I still can’t quite believe it happened to us all.
    0:42:10 And I got quite heavily involved in the lobbying.
    0:42:13 – Yeah, I read that you lobbied the UK government
    0:42:16 for COVID relief funding for the theater sector.
    0:42:19 – Very much so, yes.
    0:42:20 It was a moment where I had to actually figure out
    0:42:24 what theater meant to the world.
    0:42:26 Why theater?
    0:42:29 Why culture?
    0:42:30 Why arts?
    0:42:32 When we were going through this absolute crisis,
    0:42:37 the very model for us,
    0:42:39 which was bringing a group of people together
    0:42:41 in a closed space, indoors,
    0:42:45 sharing an experience,
    0:42:47 that whole idea was under threat.
    0:42:50 But in those dark hours,
    0:42:54 it became quite clear to me
    0:42:56 that theater will never, ever, ever, ever die.
    0:43:01 It’s absolutely essential for our mental health
    0:43:06 and our ability to communicate with one another,
    0:43:11 our ability to have empathy.
    0:43:14 We do something beautiful and unique,
    0:43:18 which is we allow people to come together,
    0:43:20 share an experience, go on a journey,
    0:43:23 think about the world in a slightly different way.
    0:43:25 And in the majority of cases,
    0:43:27 feel a little bit better about the world.
    0:43:30 And then, you know, I put on my political lobbying hat.
    0:43:34 We also feed the economy.
    0:43:37 We also feed the ecosystem around the towns and the cities.
    0:43:41 And we feed the bars and the restaurants
    0:43:43 and we create employment.
    0:43:46 We are more than just a luxury.
    0:43:48 You know, we’re at the center of every policy.
    0:43:51 And I’m talking to the Labour Party at the moment
    0:43:53 in the UK about all of this,
    0:43:55 because they get it, they get it.
    0:43:57 – And they’ll soon be in power.
    0:43:59 – Oh, I expect so.
    0:44:00 And in America and in the UK,
    0:44:02 the fact that theater and artists
    0:44:05 have to still fight for their relevance,
    0:44:07 the fact that we still have to fight for the right
    0:44:11 for children, to see shows, to read plays,
    0:44:15 to study art, to study music in schools
    0:44:19 is so short-sighted because, you know,
    0:44:22 almost every great person who walks the planet
    0:44:24 has had some experience as they grow up
    0:44:27 of being in a school show, being in a school play,
    0:44:30 or going to watch one and it can change their lives.
    0:44:33 – On that note, the changing of a life.
    0:44:39 I went back to David Ajmi.
    0:44:42 He had been writing plays for a couple of decades
    0:44:44 in relative obscurity until Stereophonic,
    0:44:47 which itself took 11 years to write.
    0:44:50 – The whole thing was written very freely
    0:44:52 and very experimentally.
    0:44:53 And I didn’t know what the structure would be early on.
    0:44:56 I just had these scenes
    0:44:57 and I didn’t know how they’d go together
    0:44:59 or what they would be.
    0:45:01 I don’t know.
    0:45:02 I just follow my intuitions when I’m working.
    0:45:04 So much of it is non-rational.
    0:45:06 It is just me kind of like tracking these characters
    0:45:08 and saying, let’s see how far I can push this.
    0:45:11 – It seems to me that the way you’re describing writing
    0:45:14 is, and maybe this is just ’cause the way
    0:45:16 I think about writing, having been a writer,
    0:45:18 my whole life is that, you know, this is how you write.
    0:45:21 You look for ideas, you find a whole lot.
    0:45:25 Most of them are terrible.
    0:45:26 You throw them away and then you sit with them
    0:45:28 and you let the unconscious come in
    0:45:31 and then you keep doing research
    0:45:33 and thinking and talking to people.
    0:45:34 But then what you try to create is an original thing.
    0:45:37 Whereas much of the theater that I’ve been seeing
    0:45:41 over the past year, especially in pursuit of this series
    0:45:44 that we’re working on, feels,
    0:45:46 what’s a non-pejorative way, constructed.
    0:45:50 I understand there’s a big market for that,
    0:45:52 probably a much bigger market for that
    0:45:53 than there is for your kind of writing.
    0:45:55 But can you just offer a sort of defense
    0:45:57 of your kind of writing for the stage?
    0:46:00 I mean, we’re used to that kind of writing in literature.
    0:46:03 But I feel like most people who think of theater
    0:46:06 don’t think of a show that’s as,
    0:46:09 not just thoughtful, but like intense.
    0:46:11 It’s an intense piece of work.
    0:46:12 It’s also fun and funny and weird.
    0:46:14 But why is there not more of this?
    0:46:17 – I don’t know.
    0:46:18 I mean, I love Goethe and German Romanticism.
    0:46:21 – I can hear all the commercial producers’ ears
    0:46:24 dropping down now.
    0:46:25 Nevermind.
    0:46:26 – And Strinberg and stuff like that.
    0:46:29 O’Neill, I mean, the great plays,
    0:46:31 the great capital G great plays
    0:46:33 are very, very freaking intense plays.
    0:46:37 They go to the bottom and I think most playwrights
    0:46:39 don’t have the courage to do it
    0:46:42 or they don’t have it in their genetic material.
    0:46:45 They don’t have it in them.
    0:46:47 And I always didn’t.
    0:46:48 I always felt like a weirdo.
    0:46:50 ‘Cause in the end, that stuff is really scary
    0:46:52 and it does scare away theaters.
    0:46:54 People don’t always wanna feel too much.
    0:46:57 They wanna go home and have their dinner after a show.
    0:46:59 They don’t wanna be ripped open.
    0:47:02 And I do think the function of art
    0:47:04 is to discomfort the comforted.
    0:47:07 And so that’s what I’m gonna do.
    0:47:10 ♪ Ooh, I’ll just call me when ♪
    0:47:15 ♪ It’s time to start again ♪
    0:47:20 – Thanks to David Ajmi along with all the performers
    0:47:25 and producers of Stereophonic who spoke with us.
    0:47:28 As I mentioned, we are working on a broader series
    0:47:31 about the economics of live theater
    0:47:32 that’ll probably come out sometime in the fall or winter.
    0:47:36 In the meantime, I would love to hear your feedback
    0:47:38 on these Stereophonic episodes
    0:47:41 and what you’d like to learn about in that later series.
    0:47:44 Our address is radio@freakonomics.com.
    0:47:48 Also, feel free to tell your friends and family
    0:47:50 to listen to Freakonomics Radio.
    0:47:52 That is a great way to support the podcasts you love.
    0:47:55 Coming up next time on the show.
    0:47:59 – I mean, this is not just a mistake.
    0:48:01 This is a crime and this is something horrible, right?
    0:48:04 – Imagine you are a big brand
    0:48:06 that hired a celebrity endorser
    0:48:09 and that celebrity does something terrible.
    0:48:12 What happens next?
    0:48:14 Not what you might think.
    0:48:17 That’s next time on the show.
    0:48:18 Until then, take care of yourself.
    0:48:20 And if you can, someone else too.
    0:48:23 Freakonomics Radio is produced by Stitcher and Renbud Radio.
    0:48:27 You can find our entire archive
    0:48:28 on any podcast app also at Freakonomics.com,
    0:48:32 where we publish transcripts and show notes.
    0:48:35 This episode was produced by Alina Cullman.
    0:48:37 Our staff also includes Augusta Chapman,
    0:48:39 Dalvin Abouaghi, Eleanor Osborn, Elsa Hernandez,
    0:48:43 Gabriel Roth, Greg Rippen, Jasmine Klinger, Jeremy Johnson,
    0:48:46 Julie Canfer, Lyric Bowditch, Morgan Levy,
    0:48:49 Neil Coruth, Rebecca Lee Douglas, Sara Lilly,
    0:48:51 Teo Jacobs, and Zach Lipinski.
    0:48:54 Our theme song is “Mr. Fortune” by the Hitchhikers.
    0:48:57 Our composer is Louise Guerra.
    0:48:59 Additional music in this episode by Will Butler,
    0:49:01 Justin Craig, and the cast of “Stereophonic.”
    0:49:04 As always, thank you for listening.
    0:49:06 If anybody ever says no to me,
    0:49:13 that’s when the green monster comes out.
    0:49:16 Wait, the green monster is envies.
    0:49:19 Is that what you mean?
    0:49:20 No, sorry, the incredible Hulk.
    0:49:26 The Freakonomics Radio Network,
    0:49:28 the hidden side of everything.
    0:49:30 Stitcher.
    0:49:35 (gentle music)
    0:49:37 you

    Broadway operates on a winner-take-most business model. A runaway hit like Stereophonic — which just won five Tony Awards — will create a few big winners. But even the stars of the show will have to go elsewhere to make real money. (Part two of a two-part series.)

     

     

     

  • EXTRA: The Fascinatingly Mundane Secrets of the World’s Most Exclusive Nightclub

    AI transcript
    0:00:00 I’m a reporter, a writer.
    0:00:06 I try to answer questions, not unlike what you do, Steven, although our questions are
    0:00:10 sometimes a bit dumber.
    0:00:12 But sometimes they’re not.
    0:00:13 Sometimes they’re smart.
    0:00:14 That is PJ Vote.
    0:00:16 He has been making podcasts for nearly as long as I have.
    0:00:19 His shows are often about life on the internet and how technology changes us.
    0:00:27 So your current show, Search Engine, despite the name, isn’t a show about life online
    0:00:33 for the most part, is it?
    0:00:35 No.
    0:00:36 The reason it’s called Search Engine is because it’s a show where it’s a bit of a joke.
    0:00:40 What is Search Engine supposed to be is like, you ask it a question and very cheaply and
    0:00:44 very quickly a machine gives you an answer that might be pretty good.
    0:00:47 We’re like a human-powered bespoke, incredibly expensive to run, very slow Search Engine.
    0:00:53 It gives answers in layers and over time, as opposed to bang, here it is.
    0:00:59 Yeah.
    0:01:00 Yeah.
    0:01:01 Oftentimes the answer is who can say.
    0:01:02 But we give you human-level, complicated and complex answers.
    0:01:08 Today, on Freakin’omics Radio, a bonus episode with PJ Vote and Search Engine.
    0:01:14 It’s sort of about economics, the economics of a famous nightclub in Berlin.
    0:01:20 I’d heard the basics.
    0:01:22 A decommissioned power plant turned into a multi-story nightclub.
    0:01:26 People talked about this place as a kind of grimy heaven and like traditional heaven.
    0:01:32 Grimy heaven was also supposedly very hard to get into.
    0:01:36 One guiding principle of our show is that just about anything can be interesting if you are
    0:01:40 willing to look closely enough or from the right angle.
    0:01:44 In this case, the door policy at a Berlin nightclub is connected to municipal tax laws,
    0:01:51 for cold war and more.
    0:01:54 But also, the Freakin’omics Radio crew doesn’t get to go clubbing very often, like never.
    0:02:00 So thanks to Search Engine and PJ Vote for letting us tag along.
    0:02:15 This is Freakin’omics Radio, the podcast that explores the hidden side of everything.
    0:02:21 With your host, Stephen Dubner.
    0:02:32 So PJ, give me the genesis of this episode of Search Engine we’re about to hear.
    0:02:37 Each of your episodes is built around a single question.
    0:02:41 Where’d the question for this episode come from?
    0:02:43 Okay, so two friends of mine, lovely young man, both kind of conscientious people.
    0:02:51 Like straight laced, buttoned up, home before midnight, hard working professional guys.
    0:02:56 They said they had a question which had sprung from a vacation they had been on and it was
    0:03:00 an unusual vacation.
    0:03:02 The two of them had flown eight hours from New York City to Germany to try to go to this
    0:03:07 techno club called Burgheim.
    0:03:09 Are you familiar with Burgheim?
    0:03:12 Before you and I started talking about this conversation that we’re having now, I was
    0:03:15 not familiar with Burgheim.
    0:03:18 It used to be before the fall of the Berlin Wall.
    0:03:20 It was a Soviet power plant in East Berlin, four stories tall, like a very imposing building.
    0:03:26 More recently, it has become a techno nightclub and supposedly the techno nightclub, like
    0:03:32 the most exclusive, fun, like everyone who loves this stuff wants to go to this place
    0:03:38 before they die, a kind of mecca.
    0:03:41 But the other thing about Burgheim is that it has the most strict and scary door policy
    0:03:47 in the entire world.
    0:03:49 They love to reject rich and famous people.
    0:03:53 A lot of the people you think would be allowed into any room have not been allowed into this
    0:03:56 room.
    0:03:57 And if you want to try to get in, you have to wait in a line that on a good night, you’ll
    0:04:01 stand in line for four hours.
    0:04:03 On a bad night, you might stand in line for eight hours.
    0:04:07 So these guys had taken an eight hour flight to Berlin to stand in a line for four to eight
    0:04:13 hours for the chance to maybe get into this nightclub.
    0:04:19 They actually stood in line three separate times.
    0:04:22 Here are Chris and Dan describing to PJ how when you get to the front of the line, you
    0:04:27 encounter the selector, the guy who decides whether you will be admitted into Burgheim.
    0:04:33 So you get up and then there’s a number of calculations that are going on in your mind.
    0:04:36 Do you look at the bouncer in the eye?
    0:04:39 Do you look kind of at the ground?
    0:04:41 Do you smile?
    0:04:42 Do you keep a straight face?
    0:04:43 Do you say anything?
    0:04:46 And I think on this try, this was like our authentic friendly selves attempt.
    0:04:51 I smiled at the guy he asked how many people were I said two, I was friendly.
    0:04:56 I think I asked him how his night was going.
    0:04:58 Did he answer?
    0:04:59 No, of course not.
    0:05:01 One of my calculations was whether or not to look like I was having fun and into the
    0:05:06 music.
    0:05:07 So I kind of like was dancing a little bit, but you know, very like minor movements.
    0:05:13 And I don’t think that strategy worked.
    0:05:17 So you walk up, you say, like, how’s your night?
    0:05:20 He says nothing.
    0:05:21 Is he just looking at you?
    0:05:22 Is it he or he?
    0:05:23 It’s a he.
    0:05:24 There’s Sven, the main bouncer.
    0:05:27 If Burgheim itself is the epitome of what you would think of East German old techno night
    0:05:33 club, then Sven is the epitome of what you would think of as the bouncer, the lead bouncer
    0:05:37 for that venue.
    0:05:38 What does he look like?
    0:05:39 A large man with a large number of tattoos and piercings on his face.
    0:05:44 And there’s two others.
    0:05:45 Apparently, there’s some sort of communication between the two of them, some sort of silent
    0:05:49 communication.
    0:05:50 But it’s not legible.
    0:05:51 There’s only one amount of legible communication and that’s the decision.
    0:05:55 And how do they communicate it to you?
    0:05:57 It’s always one person they pull up at a time or a small group.
    0:06:01 And sometimes they’re immediately rejected.
    0:06:03 Like they don’t even get to say a word.
    0:06:05 The bouncer just puts his hand out and they just keep walking.
    0:06:09 Pretty subtle.
    0:06:10 Yeah.
    0:06:11 And they just point towards the street.
    0:06:12 It’s not so much a point as an open palm out the direction that you should be going.
    0:06:17 So the gesture you’re doing is actually the gesture one used to be like, welcome to my
    0:06:20 home, but it’s welcome to not my home.
    0:06:22 The arm goes out, the palms outstretched.
    0:06:24 Like, look at this, you’re not going to a night club.
    0:06:27 Yeah, I’d say you’re welcome to go anywhere else in Berlin.
    0:06:34 You can probably tell from that part of the conversation how things went for Chris and
    0:06:39 Dan.
    0:06:40 Here’s PJ again.
    0:06:41 They flew to Berlin.
    0:06:42 They tried three separate times across three separate days to get into this place.
    0:06:47 They were rejected each time.
    0:06:49 And there was just something about the draw of, these guys are, they’re not people who
    0:06:54 are like, if there’s a red velvet rope, I got to be on the other side of it.
    0:06:57 They’re not sceny guys.
    0:06:59 It was like the fact that they were willing to spend their vacation just standing in a
    0:07:05 line and being told, no, maybe very curious about them and this place.
    0:07:09 Okay.
    0:07:10 So that’s what you need to know to get started here now from the search engine podcast is
    0:07:14 an episode called, why didn’t Chris and Dan get into Burghain with PJ vote?
    0:07:28 When we started all this last July, all I really knew about Burghain was that it was a Berlin
    0:07:33 techno club and that it was very hard to get into, but I started researching.
    0:07:39 The club itself maintains a very minimal footprint online.
    0:07:42 200,000 people follow Burghain’s Instagram account, but the club has only ever posted
    0:07:47 one photo in 2015, a picture of a sign that says in all caps, taking photos is not allowed.
    0:07:53 The sign presumably from inside the club itself.
    0:07:57 Burghain, like Vegas, claims that what happens there stays there, except in Burghain, that
    0:08:02 seems to actually be true.
    0:08:05 Some information about the club nevertheless has circulated.
    0:08:08 The story of Burghain, as I now understand it, begins 30 years ago.
    0:08:15 In the early 1990s, two Germans, Norbert Thormann and Michael Teufela, had begun hosting a men’s
    0:08:21 only gay fetish party, sometimes at an abandoned air raid shelter.
    0:08:26 After a few years, the party outgrew that bunker, the pair took over an abandoned railroad
    0:08:31 depot.
    0:08:32 At the railroad depot, they started a club called Ostgut.
    0:08:36 Ostgut is legendary, open to people of all genders and sexualities, but still a space
    0:08:41 run by and largely for gay men.
    0:08:43 A den of hedonism where consenting adults supposedly engaged in all sorts of unusual
    0:08:49 behavior, online at least one video survives from inside the club, but the video is pretty
    0:09:01 tame.
    0:09:02 It’s from July 2000, looks like camcorder footage, a grainily shot DJ hovers over a
    0:09:07 console, twiddling knobs, while nearby, a crowd of German shadows rides under a strobe
    0:09:13 light.
    0:09:20 Ostgut may have lived forever, except the city wanted to build a big arena, so the railroad
    0:09:26 depot was knocked down in 2003.
    0:09:29 Burgheim was its reincarnation, the palace that replaced Ostgut, this time too big to
    0:09:35 knock down.
    0:09:36 A thermal power plant originally built by the Russians in the Soviet era, four floors,
    0:09:42 on the very bottom floor, a dedicated basement gay club for men only, at the very top, a
    0:09:48 bar with big windows opening onto a panoramic view of the city, on the floors in between
    0:09:53 where the power turbines once sat, an enormous dark cavern, the main dance area, the entire
    0:09:59 space governed by its own particular rules.
    0:10:03 Burgheim is best known for one weekly party, club night.
    0:10:23 Club night is a misnomer, because while the party starts Saturday evening, it continues
    0:10:27 all the way until Monday morning without interruption.
    0:10:30 A few books document the history of the scene that birthed this party.
    0:10:33 I’ve found Tobias Rapps lost in sound to be particularly helpful.
    0:10:38 He writes about how when Burgheim opened in 2004, the party was by and for Berliners,
    0:10:43 but word soon spread internationally.
    0:10:46 A European budget airline called EasyJet had just opened a new hub in Berlin, and other
    0:10:51 Europeans started taking EasyJet flights to the city to come party.
    0:10:56 The legend kept growing, eventually it grew large enough to draw Chris and Dan, two of
    0:11:00 the many Americans who made the pilgrimage to techno mecca.
    0:11:04 It was a marvel.
    0:11:05 A three-day party, good enough to draw thousands of people, every weekend, people who would
    0:11:10 fly to Germany without even a promise they would gain admittance.
    0:11:15 That was club night at Burgheim.
    0:11:19 Most of what people discuss online is not any of this.
    0:11:22 Instead, they talk about Sven, the intimidating bouncer who Chris and Dan encountered and
    0:11:27 then cowered in front of.
    0:11:29 Sven Markhardt.
    0:11:31 Sven Markhardt is a tall, imposing man in his early 60s with giant lip rings that look
    0:11:37 like silver fangs.
    0:11:39 His hair is slicked back in silver, tattoos of thorns cover much of his face.
    0:11:44 He looks like a bad guy in a John Wick movie, and he has played a bad guy in a John Wick
    0:11:48 movie.
    0:11:49 That was just a cameo one time, though.
    0:11:51 Sven has run security at Burgheim since club first opened 20 years ago.
    0:11:55 Sven’s backstory, he grew up in East Berlin, the communist side of the wall, before it
    0:11:59 fell.
    0:12:00 There’s this one documentary, Berlin Bouncer, that profiles Sven.
    0:12:09 In one scene, he gives a talk in front of a crowd.
    0:12:11 He’s wearing all black, tinted glasses.
    0:12:14 Sven discusses the early chapters of his life, how his teenage years were defined by the
    0:12:18 feeling of being stuck outside a much more significant kind of door.
    0:12:31 Sven saying, “We just wanted to see the other side of the wall.
    0:12:34 We didn’t really want to leave home, we just wanted to find out.
    0:12:37 What were we being deprived of?
    0:12:39 What weren’t we allowed to see?”
    0:12:41 Sven has said that as a young, gay punk rocker, living in East Berlin was risky.
    0:12:46 He was frequently picked up by the secret police.
    0:12:48 He was devoted to his photography career, but after the wall fell, he chose to stay on
    0:12:53 the East Berlin side, and his art career stalled there.
    0:12:56 Sven’s brother was a DJ, and Sven started working the door at his parties.
    0:13:01 It turned out, Sven’s eye for people worked not just in photography, but also here.
    0:13:06 He had a talent for deciding who should be let in.
    0:13:10 He developed a reputation.
    0:13:11 That’s why they chose him for Ausgut, and later for Burgheim.
    0:13:16 The fact that this much of Sven’s biography exists in public, of course, goes entirely
    0:13:21 against Burgheim’s secretive ethos, but Sven has continued to pursue his photography career,
    0:13:27 and so every few years, when he has a new exhibition or a photo book, he talks to journalists.
    0:13:33 Questions about his photography, which he wants to discuss, and questions about how to
    0:13:37 get into Burgheim, which he has to tolerate.
    0:13:40 Those are the terms under which the gatekeepers at places like the New York Times or GQ will
    0:13:45 allow Sven entry, and understanding the way of these things, he obliges.
    0:13:51 Sven, the man with the answer to our question, what was the bouncer at Burgheim scanning
    0:13:58 you for?
    0:13:59 I should say, I emailed Sven and requested an interview.
    0:14:02 I’ve never been less surprised to not get a reply, but in the documentary, there’s
    0:14:06 this prickly moment where the interviewer seems to have directly asked Sven the rules
    0:14:11 of the door.
    0:14:12 Sven responds, not with helpful tips about what shade of black to wear.
    0:14:22 Instead, he says sternly, “We don’t need to question the rules that are in place.”
    0:14:28 He does allow that, as a selector, his responsibility is to only let people in who, once they join
    0:14:34 the party, won’t impede the freedom and self-expression of the people who are already
    0:14:39 inside.
    0:14:46 It makes sense, but it does not provide clues, and in any situation in which official sources
    0:14:52 remain this tight-lipped, speculation will reign, and it does here, mostly on TikTok.
    0:14:58 They’re a cottage industry of people who claim to have gotten through the door, now
    0:15:02 style themselves as helpful experts, explaining what exactly they believe Sven is scanning
    0:15:07 for when he looks at people like Chris and Dan, trying to get inside the mind of a 62-year-old
    0:15:13 gay German ex-punk.
    0:15:15 Be really casual, don’t be flamboyant, don’t speak too much.
    0:15:19 Don’t talk too loud in the queue, and, under no circumstances, engage in law-tar.
    0:15:26 Literally, just basically be as casual and blended as possible in order to get in.
    0:15:31 It’s impossible to know if any of these people are actually telling the truth, again, you
    0:15:34 can’t record inside a burghine, which means you just have to take their word for it.
    0:15:54 The advice offered by these supposed gurus frankly does not feel all that usable.
    0:15:59 Try to get in or maybe don’t.
    0:16:05 My favorite artifact of all the online burghine speculation is this website called burghintrainer.com
    0:16:12 that will actually drop you into a surprisingly high-res simulation of the burghine line.
    0:16:18 The site takes control of your webcam and then scans your face, analyzing your emotions through
    0:16:23 your expressions, how angry, sad, euphoric your face is, giving a virtual simulation
    0:16:29 of Sven’s gaze, and then the first-person video virtually walks you step by step up
    0:16:36 to the doors of burghine.
    0:16:38 The music gets louder as you get closer.
    0:16:41 The website warns you that Sven will ask you three questions, so I did it.
    0:16:48 When I arrived at the virtual door, a German man, presumably an actor playing Sven, asked
    0:16:53 “Is this your first time here?”
    0:16:55 I said “Yes.”
    0:16:56 “We’ve already played?”
    0:16:57 He asked “Do you know who’s DJing tonight?”
    0:17:00 I said “Yes.”
    0:17:01 “Did you take anything?”
    0:17:02 He asked “Whether I’d taken drugs?”
    0:17:04 I said “Nine.”
    0:17:07 After a moment of scanning, the virtual bouncer told me “Not good today.”
    0:17:12 And then made the hand gesture toward the street.
    0:17:16 The same hand gesture Chris and Dan had gotten.
    0:17:19 To be honest with you, this rejection by a fake bouncer, it hurt my real feelings.
    0:17:24 I’ll tell you something about myself that won’t surprise you.
    0:17:28 I’ve never been considered cool.
    0:17:30 I know cool people.
    0:17:31 I’m not against coolness, I just don’t possess it.
    0:17:35 I’m uncool enough that I often ask the cool people I know to explain to me why certain
    0:17:40 things are cool right now.
    0:17:42 How did we decide big pants are back in style?
    0:17:45 If you have to ask, you’re not cool, and I do have to ask, both professionally and
    0:17:49 just because of my personality.
    0:17:52 So I’m not cool, and I’m old enough to be okay with that.
    0:17:56 But this was a little different.
    0:17:58 At Berghain, where Sven ruled, it seemed to me that the source of his power lay partly
    0:18:03 in his refusal to explain himself.
    0:18:06 My job as a journalist was the opposite, to understand and explain.
    0:18:10 And I just couldn’t resist the challenge of trying to understand something that was
    0:18:14 designed to obscure itself.
    0:18:17 That was why, even after all this internet sleuthing and documentary watching, we would
    0:18:22 continue digging for the better part of a year.
    0:18:24 We’d talk to lots of people, we’d read too many books devoted to the telemedic study of
    0:18:28 German techno, its origins and sub-genres.
    0:18:31 And in the end, we’d emerge with an answer.
    0:18:35 What was Berghain scanning for, and why?
    0:18:38 How would a place like this come to pay?
    0:19:07 In America, in the circles I run in, people complain a lot about capitalism.
    0:19:15 I don’t think they’re bothered by the exchange of goods and services.
    0:19:18 I think it’s their shorthand way of saying everything here is just too driven by profit.
    0:19:23 Even things that start out good can be squeezed to death by our ceaseless desire to bring
    0:19:27 out every possible dollar.
    0:19:30 In Berlin, a place where until recently capitalism and socialism both operated, in Berlin, it
    0:19:36 feels like something else is going on.
    0:19:38 The nightlife industry there brings in $1.5 billion dollars a year, but they’re strange
    0:19:43 dollars.
    0:19:45 The crown jewel, Berghain, operates by turning away thousands of paying customers.
    0:19:50 And despite demand, it keeps its ticket prices pretty low, all while existing in a building
    0:19:55 that is 37,600 square feet in a very hip neighborhood.
    0:20:00 And not only does this all seem to work, it’s worked for a long time.
    0:20:04 That doesn’t happen in nightlife.
    0:20:05 Don’t stick around.
    0:20:07 Studio 54 was open for less than three years.
    0:20:10 Berghain is on its 20th.
    0:20:12 And people attribute a lot of that success to Berghain’s strict and strange door policy.
    0:20:18 You can tell the story of that door as a story about culture, about cool, but cool we know
    0:20:24 never explains itself.
    0:20:26 So let’s get inside Berghain from a different direction.
    0:20:28 I’m going to tell you the story not about DJs and bouncers, but about lawyers and lobbyists,
    0:20:35 but the municipal regulation and policy that allows this club to exist the way it does.
    0:20:41 A story that begins in 1949.
    0:20:45 Hi, can you hear me?
    0:20:46 Hey, I hear you well.
    0:20:48 How’s it going over there?
    0:20:49 Well, well, well.
    0:20:52 Lutz Leitzenring.
    0:20:53 I’d first heard about him from one of my best friends, Kay Burke, a nightclub founder herself.
    0:20:58 People in Berlin called Lutz the mayor of the city’s nightlife.
    0:21:01 So did Kay explain who I am and what we’re up to over here?
    0:21:05 I think she might, but it was also quite some time ago, so maybe you can fill me in again.
    0:21:10 Yeah.
    0:21:11 So I have this podcast called Search Engine where we just try to answer people’s questions
    0:21:16 no matter how simple or complicated.
    0:21:19 We do really serious stuff.
    0:21:21 We just did something about fentanyl and the drug supply in America, but we also do really
    0:21:26 silly stuff and kind of everything in between.
    0:21:29 In what level are we here in this conversation?
    0:21:32 We’re closer to silly, I think.
    0:21:34 So we have these friends I want to tell you about who just didn’t get into Burghide and
    0:21:38 are confused about it, but it’s sort of an excuse to tell the larger story about nightlife.
    0:21:44 I think for people in the United States, it’s a place you go and you spend $500 on champagne,
    0:21:49 and you know what I mean.
    0:21:50 Or $10 on a can of beer without a glass.
    0:21:55 Exactly.
    0:21:56 Clubs like Loots call this style of nightclub bottles and models, shorthand for the economic
    0:22:00 model that drives them.
    0:22:02 Clubs like these are what most Americans think of when you say nightclub.
    0:22:06 Spots that tend to make their money by enticing rich people to pay for tables and buy bottles
    0:22:10 of champagne so that they can feel important.
    0:22:13 The clubs are like little status factories.
    0:22:16 In Berlin, though, that same word, nightclub, describes an entirely different operation
    0:22:21 fueled by a different economic model.
    0:22:23 Loots’s job is to protect that status quo.
    0:22:26 He’s nightlife’s advocate in the offices of city bureaucrats.
    0:22:30 The spokesperson for Berlin’s Club Commission.
    0:22:33 I wanted Loots to tell me how Berlin’s unusual nightlife scene had come to be, and that story
    0:22:39 is the story of two arguments.
    0:22:42 The first argument takes place in the late 1940s.
    0:22:45 Argument one is about a very specific rule, curfew.
    0:22:49 In Berlin today, there is no curfew.
    0:22:51 Members and clubs stay open as long as they want.
    0:22:53 Can you tell me the story of how Berlin came to be a city with no curfew?
    0:22:58 What is the origin story of that decision?
    0:23:00 The decision is almost 80 years old, and it happened right after World War II.
    0:23:07 In 1949, you had already a divided city between the Eastern sector and the Western sector.
    0:23:12 The Eastern sector controlled by the Russians, and the Western sector controlled by the British,
    0:23:17 the French, and the Americans.
    0:23:19 In the Eastern part, there was a curfew at 10 p.m.
    0:23:23 All the restaurants, bars, hotel bars, cabaret bars, they had to close at 10 p.m.
    0:23:29 In the Eastern part, in the Western part, it was 9 p.m., so an hour earlier.
    0:23:34 There was this, let’s say, representative of the hotels and restaurants of Berlin.
    0:23:38 His name was Heinz Zellermeyer.
    0:23:40 Heinz Zellermeyer.
    0:23:42 There was no Club Commission back then.
    0:23:44 Heinz was instead the deputy director of the Guild of Berlin Hotelliers.
    0:23:50 In photos, Heinz has an enormous smile and combed back hair.
    0:23:53 He looks like someone who held forth at a restaurant or two.
    0:23:58 Heinz did not like the curfew.
    0:24:00 He particularly did not like that his side of the city had an earlier curfew.
    0:24:04 The person to complain to was General Howley of the U.S. Army, the American’s West Berlin
    0:24:09 commandant.
    0:24:10 A meeting was set, and Heinz supposedly came prepared.
    0:24:14 The story is that he brought a bottle of whiskey to that meeting, so they met, and they were
    0:24:20 talking about it, and General Howley said, “Yeah, the British and the French, they are
    0:24:24 not really supporting any idea of losing this curfew.
    0:24:28 They say it’s a security issue, so you have to give me an argument that I can give to
    0:24:33 French and the British.”
    0:24:34 The problem was that at that moment, in the Western part, the people had to go out of
    0:24:37 the bar, and then they went to the Eastern sector for another hour, which was also not
    0:24:41 really liked by the Americans.
    0:24:43 He said, “If you kick Germans who are partying at a certain hour, you kick them out of the
    0:24:48 street, you’re going to have a security issue, so you have to better find a solution for
    0:24:52 it.”
    0:24:53 It was a well-raised argument.
    0:24:55 The Allies did not want drunk Westerners crossing East in search of a later last call.
    0:25:00 And worse, there had been an emerging Cold War of curfews, with each side, the East and
    0:25:05 the West, repeatedly extending an hour past each other to try to capture all the income
    0:25:10 from drunk Berliners.
    0:25:12 curfew would solve the security issue and win the night war.
    0:25:16 General Howley was sold.
    0:25:17 He said, “Okay, let’s try this out for two weeks, and since then, 1949, we have no curfew.”
    0:25:23 Berlin, one of the rare cities that has no curfew at all.
    0:25:28 In 1949, when the city permanently deleted its curfew, obviously, techno music did not
    0:25:32 exist.
    0:25:33 Raving was something people did in insane asylums.
    0:25:37 If anyone was listening to music in a club late at night, it was probably jazz.
    0:25:41 But this decision set Berlin on a path.
    0:25:45 Nightlife is funded more than anything else via the sale of alcohol.
    0:25:49 A city without a curfew can have a legal party that runs through the night, even that runs
    0:25:53 multiple nights.
    0:25:55 Half a century-ish later, techno will hit Berlin.
    0:25:59 People will begin to throw raves in illegal spots without permits.
    0:26:02 This will happen in a lot of cities at the same time, Detroit, New York, London.
    0:26:07 But what makes Berlin different from those places is that here, many of those raves can
    0:26:12 actually become legitimate businesses, can find permanent homes and clubs.
    0:26:17 General Howley’s 1949 agreement is the first precondition for Klubnacht at Burgheim.
    0:26:23 It sets the stage for a party that can last for three days.
    0:26:27 But years later, as the scene starts to mature, a second argument takes place, an argument
    0:26:32 which almost kills these nightclubs.
    0:26:35 Argument two is about taxes.
    0:26:40 In the early 2000s, Burgheim was a rising young club, alongside already-established
    0:26:44 spots like Trissor and the Kit Kat Club.
    0:26:48 And Berlin’s tax authority started to take a closer look at these places.
    0:26:52 How much money were they bringing in?
    0:26:54 Shouldn’t the city be getting a bigger cut?
    0:26:57 Government tax agents walk into Burgheim, presumably without needing permission from
    0:27:00 Sven.
    0:27:01 They’re there documenting everything they see.
    0:27:03 Asking a question, from a tax perspective, what is happening in these rooms?
    0:27:09 In Germany, if you pay money for a ticket and enter a venue where music is played, you
    0:27:14 may be having one of three different experiences.
    0:27:17 You might be experiencing high culture, like opera, in which case the city will barely tax
    0:27:21 the ticket.
    0:27:23 You might be at a concert, like the Rolling Stones, in which case the city will moderately
    0:27:27 tax the ticket.
    0:27:29 Or you might be experiencing entertainment.
    0:27:33 This happens in casinos, in porn theaters.
    0:27:36 In that case, the city will take a big tax bite, almost 20%.
    0:27:41 Before the tax officials began to take a closer look at the club scene, these venues had been
    0:27:46 mostly taxed as concert venues.
    0:27:48 But now, in 2008, the city started to ask pointed questions.
    0:27:53 Was a DJ really a musician?
    0:27:55 Was a techno show really like a concert?
    0:28:01 The perception that people in government had says, “A DJ is not a concert.”
    0:28:05 People are going there to have sex or to drink or to whatever, but not because of the DJ.
    0:28:10 They even sent people to clubs and documented that people were not facing the artists.
    0:28:16 They were talking to each other, stuff like that, to kind of prove the point that this
    0:28:21 is not a concert.
    0:28:22 Wow.
    0:28:23 I’ve been to concerts where people were not facing the artists and talking to each other.
    0:28:28 Exactly.
    0:28:29 They said clubs is different, people go there to meet people, not because of the artists.
    0:28:34 They don’t even know who’s playing these kind of argumentations.
    0:28:37 Burgheim was the club that actually took this case all the way to the high courts.
    0:28:42 Burgheim won.
    0:28:43 The Burgheim, in the government’s books, was cemented as a concert venue, a place where
    0:28:47 people went because they loved techno music.
    0:28:50 Weirdly, this is one part of the answer to Chris and Dan’s questions.
    0:28:54 What was the bouncer, Sven, scanning for at the door?
    0:28:58 He needed to ensure they were true techno heads, not people there simply for entertainment.
    0:29:03 That consideration, a funny side effect of the argument the club had had to make in court
    0:29:07 years ago.
    0:29:08 It may have been part of what filtered them out.
    0:29:11 Chris and Dan, not true techno heads.
    0:29:15 Burgheim’s victory in court meant that any German nightclub that could prove it was meeting
    0:29:18 Burgheim’s cultural standards could be taxed like Burgheim.
    0:29:23 Lower taxes meant they could keep their overhead low, the lower the overhead, the less pressure
    0:29:27 to make money, the less pressure to make money, the more they could continue to keep their
    0:29:31 nightclubs dedicated to preserving Berlin’s counterculture.
    0:29:34 We’re going to come back to this strange court case and its consequences, but before
    0:29:40 I left Lutz, I wanted to ask him specifically about Chris and Dan.
    0:29:45 What was it about them, the way they looked, the way they dressed, that had signaled they
    0:29:49 didn’t belong at Burgheim?
    0:29:51 Just to be clear, Lutz does not represent Burgheim, but as spokesperson for the club
    0:29:56 commission and as a Burgheim regular, I thought he might be able to help.
    0:29:59 Can I show you a couple of photographs and you tell me if the person seems like…
    0:30:03 I’m not a selector, so I can only give you my personal opinion.
    0:30:06 Yeah.
    0:30:07 Is it okay to ask you your opinion on it?
    0:30:09 Yeah, I’m sure.
    0:30:10 Of course.
    0:30:11 Okay.
    0:30:12 This is one person.
    0:30:13 Well, very friendly, maybe queer person, very soft, happy, he’s wearing some kind of top
    0:30:23 top that doesn’t really say anything.
    0:30:26 It’s too generic of a top, the vest.
    0:30:31 I think it looks authentic to him, but this person looked very innocent.
    0:30:37 And you also want to save some people for getting into something that they maybe don’t
    0:30:44 expect.
    0:30:45 Okay, so this is the person he went with?
    0:30:49 Yeah.
    0:30:50 I would probably send them to Schwartz.
    0:30:52 It’s our oldest, best known gay club, and that’s the perfect vibe for those two guys.
    0:31:00 Because they don’t seem like techno guys to you, they seem like gay guys who are going
    0:31:04 out clubbing.
    0:31:05 They don’t look like hard standing in the middle of a sweaty club and going for hours
    0:31:12 and enjoying this.
    0:31:14 And they’re standing more like having a chat.
    0:31:17 And that’s okay to have some of those folks in the venue, but it’s really about getting
    0:31:22 out of your inner self and showing your animalistic side of yourself.
    0:31:28 For very good reason, we don’t celebrate the idea that you should judge people based
    0:31:32 on how they look on the outside.
    0:31:34 Those judgments often lead us astray.
    0:31:36 And yet, Lutz from a photo could tell Chris and Dan were after respectful, healthy, wholesome
    0:31:44 partying, not the sort of darkness that occurs in Burghine’s techno dungeons.
    0:31:50 They didn’t belong here.
    0:31:51 They belonged, he’s suspected, at another place called Schwartz.
    0:31:55 I wondered what Chris and Dan would make of that judgment.
    0:31:58 So later, I asked.
    0:32:01 Chris told me Schwartz?
    0:32:03 They loved Schwartz.
    0:32:04 It was the club they’d ended up at after being rejected from Burghine.
    0:32:08 Berlin, this magical city, had somehow sent them to the place where they really belonged.
    0:32:14 Lutz was not a selector, but he did seem to have a selector’s eye.
    0:32:19 Your read is so good.
    0:32:20 Chris, who I know better, he’s a lovely, he’s one of my favorite people to spend time with.
    0:32:24 If I were having a party, what was really important that someone danced in the middle
    0:32:28 of the dance floor for eight hours, he would perhaps not make the cut for that party?
    0:32:32 I think the first question you have to ask yourself, are you a participant or are you
    0:32:37 a visitor?
    0:32:39 And it shouldn’t sound sophisticated or arrogant.
    0:32:42 It’s just like a club.
    0:32:44 The definition of club is being part of a club.
    0:32:49 If you’re not part of the club, why should you being able to enter?
    0:32:53 I think the idea of just buying myself in is the opposite of a club, what it should
    0:32:58 actually be.
    0:32:59 A club should bring people together who have similar interests, similar preferences.
    0:33:05 A club should bring together people of similar interests.
    0:33:08 Absolutely.
    0:33:09 But whatever you’re someone who doesn’t belong, but still wants to just go check it out.
    0:33:14 Is there a way to sneak in?
    0:33:15 Is there some other way into Burgheim that is not going through the bouncer?
    0:33:20 Lutz did have advice about this.
    0:33:22 My tip that I usually give is make a plan of exploring Berlin, maybe from the outskirts.
    0:33:30 Go to venues that are not very known.
    0:33:32 Go to places that are somehow interesting for you because you did your research and you
    0:33:39 saw some artists that you want to see and yet they’re playing, so go there.
    0:33:42 And you get in very easy because venues that are not very known don’t have this kind of
    0:33:47 level of selection.
    0:33:49 Usually there’s not even a queue.
    0:33:51 And then you get friends with the bartenders, you make friends with the DJs there.
    0:33:55 And you have an amazing time in an unknown venue with unknown artists, basically.
    0:34:02 And the next time you’re coming, you’re going to reach out to them.
    0:34:06 And because they liked you or they connected to you, they will ask you to start in their
    0:34:11 home with dinner, maybe you go to a bar, you make a no-friend, and even maybe they make
    0:34:16 sure that you get on a guest list of some venue that they are going at that night.
    0:34:21 But I think it’s part of that journey that you also have to make to be part of the scene.
    0:34:28 Lutz said the process he’s describing, this is the real way into Klubnacht.
    0:34:33 Make yourself a part of the scene.
    0:34:35 That line outside Burgheim, he said, that’s for people who haven’t been able to or who
    0:34:39 haven’t known to try.
    0:34:42 While Lutz was saying this to me, I was nodding yes furiously, my noggin like a broken bobblehead.
    0:34:47 Of course it all made sense.
    0:34:49 And as a person obsessed with belonging and exclusion, I was lapping it all up.
    0:34:55 We finished our conversation.
    0:34:57 We hung up, and then, not long after, this spell of Lutz’s idea dissipated.
    0:35:04 What were we talking about?
    0:35:06 If you wanted to visit the most exclusive nightclub in the world, go to Germany and
    0:35:10 start methodically befriending Germans in the city’s electronic music scene.
    0:35:14 Okay.
    0:35:15 Normally, that would have been the end of things.
    0:35:20 And perhaps it should have been the end of things.
    0:35:23 But not long after this, a friend of mine, an American, asked me a question.
    0:35:29 They were celebrating a big milestone in their life, and they wanted to do it in Germany.
    0:35:33 In Berlin, actually.
    0:35:34 They wanted to spend some time there, perhaps even try to see some of the city’s famous
    0:35:38 nightlife.
    0:35:39 Did that sound like fun?
    0:35:40 Could I make some time away from work?
    0:35:42 Yes, it did.
    0:35:43 No, I couldn’t.
    0:35:45 I bought myself a plane ticket.
    0:35:49 That again was PJ Vote, with the first part of a two-part story to hear what happened
    0:35:54 after he got to Berlin.
    0:35:56 Go get Search Engine in your podcast app.
    0:35:59 I’ll be talking to PJ a bit more after the break.
    0:36:14 The Bergheim Nightclub sits at the intersection of what used to be East and West Berlin.
    0:36:20 Its name comes from the two districts on either side, Kreuzberg in the West and Friedrichsheim
    0:36:25 in the East.
    0:36:26 PJ Vote’s last name, which is spelled V-O-G-T, is also German.
    0:36:32 Vote is referred to some sort of feudal landowner, kind of the middle manager of whatever the
    0:36:39 feudal era.
    0:36:40 It was not a very high status position, but high status enough that people might not like
    0:36:43 you.
    0:36:44 Do you feel you have a little bit of ancestral, if only impressionistic, connection to your
    0:36:49 German roots?
    0:36:50 I didn’t think so until I went, and I was not expecting to feel anything at all.
    0:36:56 And I felt so much in a way that kind of shocked me, actually.
    0:37:00 When did you first go to Germany?
    0:37:02 I actually went on a reporting trip for this story.
    0:37:07 This was the first time you’d been to Germany?
    0:37:09 Okay, that’s not entirely true.
    0:37:10 I went once as a 17-year-old, you could do that Euro rail thing.
    0:37:15 And so I did that for a minute, but I didn’t crack the surface of the city in any meaningful
    0:37:19 way.
    0:37:20 And this was the first time where I really felt like, I don’t know, I felt the weight
    0:37:25 of the history.
    0:37:26 I felt this feeling that Berlin is a place that is both, I hate when people over generalize
    0:37:31 about places that they visit for a week, but I thought these are people who believe in
    0:37:36 order and following rules, sometimes to great historical tragedy, but who also, like everything
    0:37:42 always exists in balance, and it’s also a place where people love to let loose and break
    0:37:48 rules.
    0:37:49 And I felt like I could feel both of those forces in a way that felt very alive to me.
    0:37:54 Was it a place that you felt oddly at home you’re saying?
    0:37:57 A little bit, yeah, which really surprised me because I tend to be skeptical about a
    0:38:02 lot of claims that like, are memories or history or somehow encoded genetically.
    0:38:07 Like I just never experienced that feeling.
    0:38:09 And so when other people talked about it, I was like, oh, that’s great for you, but
    0:38:12 I never expected to feel it.
    0:38:13 And I felt both, I felt, I got there and like, I’m not Jewish.
    0:38:18 My grandfather was Jewish and he converted, but I felt that stuff a little bit in a way
    0:38:22 that I wouldn’t have thought.
    0:38:23 And then I also felt German stuff in a way that I wouldn’t have thought.
    0:38:27 It was like someone having a mildly religious experience who is a pretty profound atheist.
    0:38:31 It really kind of wobbled me.
    0:38:33 In retrospect, do you think one reason you chose to answer this question about Berghain
    0:38:39 was because it afforded you the opportunity to go to your ancestral homeland as faint as
    0:38:43 the connection might have been?
    0:38:45 Yeah, although I would not have known that until you asked that question.
    0:38:48 Did you spend time inside Berghain?
    0:38:51 I did.
    0:38:52 Weren’t?
    0:38:53 I made a promise I wouldn’t talk about what I saw in detail, but I will say-
    0:38:57 Who did you promise?
    0:38:58 And do I care that you promised to them?
    0:39:00 I promised myself, I was like, I really, so it’s funny.
    0:39:02 When I walked up to the club, I felt like such a schmuck, Stephen.
    0:39:06 So one of the things about Berlin that also I thought was really brilliant is that they
    0:39:11 do not allow cell phones in any of these spaces.
    0:39:14 Don’t put a sticker over your camera.
    0:39:16 If you whip that thing out, you’re out.
    0:39:18 You’re out right away.
    0:39:19 It really makes spaces feel different to have people not be on their phones.
    0:39:24 Berghain, its roots are as a gay club and its real roots are as like a really profoundly
    0:39:30 dirty gay sex club.
    0:39:32 And I’d say dirty without judgment.
    0:39:35 There’s one section that is still devoted to that that is easier to get into, but the
    0:39:38 dress code for like a Friday night is socks.
    0:39:42 So I didn’t go.
    0:39:44 But even the main club is like, it’s like a space that’s devoted to that.
    0:39:47 And so you already feel like an interloper and the rule is sort of like this is a place
    0:39:51 where adults can do whatever they want and where they’re guaranteed privacy and nobody
    0:39:55 talks about it.
    0:39:56 It’s basically like German cultures realize they really don’t like surveillance for very
    0:39:59 specific historical reasons.
    0:40:00 I found it to be like an entirely, all this just makes me sound like such a kook.
    0:40:05 But like, I was like, this place is profound.
    0:40:08 Like it feels profound to be in a place where like, I don’t know, really dedicated to complete
    0:40:15 self-expression where nothing that happens gets judged.
    0:40:21 I mean, I went on a Sunday afternoon, it was like 2pm.
    0:40:25 There were Berliners there who were just that was their Sunday.
    0:40:28 That’s what they always do.
    0:40:29 Those aren’t people who wait in line.
    0:40:30 There were people who probably been waiting for eight hours and just gotten in and were
    0:40:33 so excited.
    0:40:35 I saw more expression of ways a human body could look or be dressed than I’ve seen in
    0:40:41 my whole life.
    0:40:43 I mean, there were things that were happening that were like very burghine-y, like they
    0:40:45 have something called a dark room, which is a room you can go in that’s very underlit
    0:40:49 where people can do what they want to do to each other, usually gay man.
    0:40:53 But there was also like, they have an ice cream parlor.
    0:40:55 I had a really nice sorbet and a cappuccino.
    0:41:00 So on Freakonomics Radio, we tend to talk to experts and academics, institutional people
    0:41:06 with credentials of one sort or another.
    0:41:09 What I love about your interviews is you will often interview people whose formal credentials
    0:41:13 may not be that impressive, but they know a lot.
    0:41:17 You are really good at getting them to teach us things that we might not find out any other
    0:41:22 way.
    0:41:23 That’s really nice to hear you say.
    0:41:24 Yeah, I think we’re good at like, sometimes people might have a really specific experience
    0:41:28 that has given them a really specific education and you just want to share that.
    0:41:33 It’s weird.
    0:41:34 This is not a thing I expected to be talking about today, but something that I got to
    0:41:39 interview the serial team when they were launching their new season, and I asked them a bunch
    0:41:44 of questions about their work, and I asked them the question I wanted to ask them, which
    0:41:47 was, do you ever grapple with just the, what are we doing here of this?
    0:41:54 Besides that it’s interesting and fun, why are we making this stuff every week?
    0:41:59 And they were like, we’re doing journalism.
    0:42:01 It’s very obviously important.
    0:42:03 It’s in the public interest.
    0:42:05 How is this a question you have?
    0:42:06 I was like, yeah, me too, but it’s a thing I really, I’m really like, what is in a deeper
    0:42:13 way the point of this?
    0:42:14 And one of the answers I sometimes audition for myself is every one of us is going to
    0:42:18 die before we die.
    0:42:20 We’re going to survive some things.
    0:42:22 And one of the things stories can be our instruction maps, and they’re not perfect,
    0:42:26 but it’s sort of like, here’s how I got out of that place with my soul intact.
    0:42:31 One of the things we do sometimes that I love when we get to do is talk to somebody who
    0:42:36 just navigated something psychologically complex and learned a couple of things about it.
    0:42:42 But in a way where you really do feel, it’s not like drink water and exercise and be good
    0:42:47 to your spouse, but more like, no, no, no, here’s how I got out of that.
    0:42:51 I really figured something out, let me tell you the trick.
    0:42:56 That again was PJ vote host of the search engine podcast.
    0:43:00 I hope you like hearing a new show in our feed once in a while.
    0:43:04 Let me know.
    0:43:05 Our email is radio@freakonomics.com.
    0:43:08 If you’d like to hear more search engine, you can get it on any podcast app.
    0:43:12 Some questions that PJ has recently asked there are, where did all the roaches go?
    0:43:18 And do political yard signs actually do anything?
    0:43:22 We will be back right here very soon with a regular episode of Freakonomics Radio.
    0:43:27 Until then, take care of yourself and if you can, someone else too.
    0:43:32 Freakonomics Radio is produced by Stitcher and Renbud Radio.
    0:43:34 You can find our entire archive on any podcast app or at Freakonomics.com, where we also
    0:43:40 publish transcripts and show notes.
    0:43:42 For search engine, this episode was created by PJ vote and Shruti Pinamanani and produced
    0:43:47 by Garrett Graham and Noah John.
    0:43:50 Back checking this week by Claire Hyman, sound design and original composition by Armin
    0:43:55 Bazarian.
    0:43:56 For Freakonomics Radio, it was produced by Teo Jacobs with help from Daniel Moritz Rabsen.
    0:44:01 Our staff also includes Augusta Chapman, Alina Cullman, Dalvin Aboulajie, Eleanor Osborn,
    0:44:06 Elsa Hernandez, Gabriel Roth, Greg Rippin, Jasmine Klinger, Jeremy Johnston, Julie Canfer,
    0:44:11 Lyric Bowditch, Morgan Levy, Neil Carruth, Rebecca Lee Douglas, Sara Lilly and Zach Lepinski.
    0:44:16 Our theme song is Mr. Fortune by the Hitchhikers.
    0:44:19 Our composer is Luis Guerra.
    0:44:21 As always, thank you for listening.
    0:44:27 This is like asking the FBI agent who listens on your phone calls to just like pop in and
    0:44:31 reveal himself.
    0:44:33 Does that work?
    0:44:34 Almost always.
    0:44:35 Almost always.
    0:44:36 The Freakonomics Radio Network, the hidden side of everything.
    0:44:49 you
    0:44:51 you

    The Berlin dance mecca Berghain is known for its eight-hour line and inscrutable door policy. PJ Vogt, host of the podcast Search Engine, joins us to crack the code. It has to do with Cold War rivalries, German tax law, and one very talented bouncer.

     

    • SOURCES:
      • Lutz Leichsenring, executive board member of Clubcommission Berlin and co-founder of VibeLab.
      • PJ Vogt, reporter, writer, and host of the podcast Search Engine.

     

     

  • 592. How to Make the Coolest Show on Broadway

    AI transcript
    0:00:00 (dramatic music)
    0:00:02 When I first moved to New York City years ago,
    0:00:06 I went to a lot of Broadway shows.
    0:00:08 My girlfriend was an actress,
    0:00:10 a lot of our friends were actors,
    0:00:12 and we would scrounge tickets for cheap,
    0:00:14 or more often we would second act the shows.
    0:00:17 That’s when you just walk in the theater at intermission
    0:00:21 and find an empty seat.
    0:00:22 It’s harder to do that these days.
    0:00:24 And then in my first real journalism job at New York Magazine,
    0:00:29 I wrote about the theater a good bit,
    0:00:31 and I was suddenly invited to become a voter
    0:00:33 for the Tony Awards.
    0:00:35 I thought this was an honor of some kind.
    0:00:37 It turned out to be more of a punishment
    0:00:40 because a Tony voter is supposed to see every show
    0:00:44 that’s nominated for any category,
    0:00:46 which means you see a lot of theater
    0:00:48 that just isn’t very good.
    0:00:51 I don’t mean to be cruel.
    0:00:53 I know that everyone involved works really hard,
    0:00:56 but making a great piece of theater,
    0:00:59 great piece of anything, takes more than hard work.
    0:01:02 It takes talent and luck and endurance,
    0:01:07 and something that feels like alchemy.
    0:01:10 Anyway, after seeing 20 or 30 Broadway shows a year,
    0:01:15 many of them mediocre at best,
    0:01:18 I pretty much gave up on it.
    0:01:20 I also stopped following the business side of theater,
    0:01:23 which I had found fascinating and weird.
    0:01:27 But I moved on.
    0:01:28 It just felt like in a world
    0:01:30 of rapidly expanding entertainment options,
    0:01:33 Broadway had been left behind.
    0:01:35 Meanwhile, the tickets kept getting more expensive.
    0:01:39 These days, the average Broadway ticket costs over $125.
    0:01:43 The average household income
    0:01:44 of a Broadway ticket buyer today is over $270,000.
    0:01:49 This steep inflation was actually predicted
    0:01:52 back in 1965 by a pair of economists,
    0:01:56 William Baumol and William Bowen.
    0:01:58 They published a paper called On the Performing Arts,
    0:02:01 The Anatomy of Their Economic Problems.
    0:02:05 Even back then, they saw that when an industry
    0:02:08 is not able to use new technologies to raise productivity,
    0:02:12 which is what most industries do,
    0:02:15 then prices would spike
    0:02:16 since the cost of labor continues to rise.
    0:02:19 This phenomenon came to be called Baumol’s cost disease.
    0:02:23 Today, it helps explain why sectors like healthcare
    0:02:27 and education have also seen massive inflation.
    0:02:31 There may be a lot of new technology in those fields,
    0:02:33 but it doesn’t change the basic fact
    0:02:35 that they require a lot of real people
    0:02:38 spending a lot of time doing or making a thing,
    0:02:42 and real people are expensive.
    0:02:46 Can you think of an industry more vulnerable
    0:02:48 to this cost disease than live theater?
    0:02:52 For starters, you can’t scale it.
    0:02:55 It takes dozens of people, sometimes hundreds,
    0:02:58 working very hard for many hours every day
    0:03:01 so that you and I can plop ourselves in a seat
    0:03:04 and watch something that is essentially handmade,
    0:03:07 and that’s not counting the thousands of hours
    0:03:10 and dollars spent creating the show in the first place.
    0:03:13 Writers, directors, producers, musicians,
    0:03:16 lighting and costume and scenic designers,
    0:03:19 then there are the staged readings and workshops,
    0:03:22 rehearsals, sometimes fistfights.
    0:03:25 But if all the elements line up,
    0:03:28 the talent, the luck, the endurance, the alchemy,
    0:03:32 it can also be something spectacular
    0:03:35 and unique every single time.
    0:03:37 A while back, we got an email from a listener.
    0:03:41 We had just put out a series on the airline industry,
    0:03:44 and this listener suggested something similar
    0:03:46 on the theater industry.
    0:03:48 So we started looking into it.
    0:03:50 We did a bunch of interviews,
    0:03:51 feeling around for a center of gravity, a hypothesis.
    0:03:56 One obvious working title came to mind.
    0:03:59 Is theater dead?
    0:04:01 Or maybe this time is theater really dead?
    0:04:05 Because the demise of theater has been predicted
    0:04:07 for decades, if not longer.
    0:04:10 It is, after all, one of our oldest art forms,
    0:04:13 going back to at least the ancient Greeks.
    0:04:15 It’s more than 2,500 years ago.
    0:04:18 And who says everything has to last forever?
    0:04:21 Maybe live theater had just outlived its time.
    0:04:25 During those early interviews we did,
    0:04:27 it became clear that the economics of theater
    0:04:30 are still fascinating and weird.
    0:04:33 For those of us in New York,
    0:04:35 Broadway is just the visible tip of the iceberg.
    0:04:39 Beneath it are many hundreds of professional,
    0:04:42 not-for-profit theaters,
    0:04:44 regionals and repertoires and university programs
    0:04:47 and others, and their economics have become dire.
    0:04:51 Even before the COVID shutdown, which hit them hard,
    0:04:55 a lot of the nonprofits were in financial trouble.
    0:04:58 Part of the problem is that they’ve always relied
    0:05:00 on philanthropic donations,
    0:05:01 and most younger donors just aren’t that interested
    0:05:04 in the theater.
    0:05:06 But this is a big problem for the commercial theater too,
    0:05:08 for Broadway, because the nonprofits are the farm system
    0:05:12 for Broadway shows.
    0:05:14 Of the 26 new plays or musicals
    0:05:17 that opened on Broadway this season,
    0:05:19 23 of them came up through the farm system,
    0:05:22 most in the U.S. and a few in the U.K.
    0:05:25 As we were trying to figure out
    0:05:27 how to make a radio series about all this,
    0:05:30 I started going to see shows again, quite a few,
    0:05:34 in New York and London and a couple other places.
    0:05:38 I am sorry to report that once again,
    0:05:40 most of them weren’t great.
    0:05:42 I’d still get excited every time the lights went down
    0:05:46 and you’d feel your heart beating faster.
    0:05:49 What am I about to see?
    0:05:51 Where will it take me?
    0:05:52 Because there is a thing that can only happen in theater,
    0:05:56 and I kept looking for it for something
    0:05:58 that didn’t feel like it was trying to be a concert
    0:06:01 or a sitcom or a theme park ride.
    0:06:04 I went to see a musical version of Back to the Future.
    0:06:07 The highlight was, toward the end,
    0:06:09 the DeLorean flying out over the audience.
    0:06:13 I didn’t actually see this happen
    0:06:14 because I left at intermission,
    0:06:16 but maybe someone else second acted the show
    0:06:19 and got to see it from my seat.
    0:06:21 I hope so.
    0:06:22 I recognize everyone has their own taste.
    0:06:24 I’m not trying to yuck anyone else’s yum.
    0:06:27 I was just looking for something
    0:06:29 that could only happen in a dark room
    0:06:31 with real people on stage doing and saying things
    0:06:36 that you won’t see or hear anywhere else,
    0:06:38 or at least not as intensely and intelligently.
    0:06:42 I guess I was looking for a jolt.
    0:06:45 And finally, I found it.
    0:06:48 And the person responsible for creating it
    0:06:51 feels the way I do.
    0:06:53 – I wanna feel electricity
    0:06:55 and I wanna feel alive in a new way.
    0:06:57 I wanna feel something unpeeling or unfolding
    0:07:01 in a very surprising way when I go to the theater.
    0:07:04 – His name is David Ajmi.
    0:07:05 He’s been writing plays for many years.
    0:07:08 This one, it’s called Stereophonic.
    0:07:11 It took 11 years.
    0:07:12 Stereophonic is about a rock band
    0:07:14 in the 1970s recording an album.
    0:07:17 It’s a show about music, but it’s not a musical.
    0:07:20 It’s got the feel of a documentary,
    0:07:22 but it’s more intimate and more interesting.
    0:07:26 It might not seem theatrical, but it is.
    0:07:29 It’s just not performative
    0:07:31 in the way that so much theater is these days.
    0:07:34 Anyway, I loved it.
    0:07:36 And I wanted to tell you about it.
    0:07:38 And I wanted to hear from the people who made it.
    0:07:41 So we are still working on that series
    0:07:44 about the economics of the theater industry.
    0:07:46 That’ll come out later this year, I hope.
    0:07:48 But Stereophonic is having a moment right now.
    0:07:52 It is nominated for more Tony Awards
    0:07:54 in any play in history.
    0:07:56 It’s the show that rock stars are going to see
    0:07:58 on their nights off.
    0:08:00 So today on Freakonomics Radio,
    0:08:02 the first of a two-part series, trust me, it’s worth it,
    0:08:06 to find out how the alchemy happened.
    0:08:09 We will hear from the creators.
    0:08:11 – We’ve been told throughout this show
    0:08:13 to have a bit of hostility to the audience.
    0:08:15 – It’s not a very fashionable play.
    0:08:17 It doesn’t have to do with identity politics.
    0:08:19 – It’s about nothing and it’s about everything.
    0:08:22 It’s about being in a room with creative people,
    0:08:26 making something or at least trying to make something great.
    0:08:29 – And we’ll hear from the producers.
    0:08:32 – If you follow a formula for Broadway,
    0:08:34 what I’ve found is the biggest successes on Broadway
    0:08:37 tend to break that formula, and this is one of those.
    0:08:41 – How to break a formula, break some hearts,
    0:08:45 and in this case, break the bank.
    0:08:48 The unlikely success of Stereophonic
    0:08:51 and what it may say about the future of live theater,
    0:08:54 starting now.
    0:08:55 (upbeat music)
    0:08:59 (clock ticking)
    0:09:02 – This is Freakonomics Radio,
    0:09:08 the podcast that explores the hidden side of everything
    0:09:11 with your host, Stephen Dubner.
    0:09:14 (audience cheering)
    0:09:17 – Going to see a piece of live theater
    0:09:25 takes time, effort, and money.
    0:09:27 Sometimes a lot of money.
    0:09:29 You could watch thousands of movies on Netflix
    0:09:32 for the cost of one Broadway ticket.
    0:09:35 So what does theater have going for it?
    0:09:38 What does it still do that nothing else can?
    0:09:41 Here again is the playwright, David Ajmi.
    0:09:44 – It is live and the audience becomes an organism
    0:09:49 and they are in collaboration with the actors.
    0:09:52 So there’s something about that kind of liturgy,
    0:09:55 the ritual of being in a space together,
    0:09:58 creating a new thing every single night
    0:10:00 because it is totally different every single night
    0:10:03 and the energy and the electricity,
    0:10:05 what makes something funny or moving one night
    0:10:08 can be completely discrepant with what happens the next night.
    0:10:12 That kind of knife edged liveness
    0:10:15 is something that you only can really get in the theater
    0:10:18 and it’s a temporal art form.
    0:10:20 It takes place within a compressed amount of time.
    0:10:23 There’s a beginning, middle, and end that you can feel
    0:10:25 when I was writing my memoir,
    0:10:27 I couldn’t get a sense of the shape because it was so big.
    0:10:30 There were so many hundreds of pages that I was like,
    0:10:32 oh my God, I can’t even get a sense of what this shape is.
    0:10:35 In a play, it’s much more skeletal.
    0:10:37 You can feel the shape of it.
    0:10:39 You can trace the vertebrae of it when you’re writing it.
    0:10:42 It’s much easier to wrap your head around it.
    0:10:44 – Ajmi grew up in a fairly strange, often dysfunctional,
    0:10:49 always loud family of Syrian Jews in Brooklyn.
    0:10:53 In his memoir, Lot 6, published in 2020,
    0:10:57 he writes about seeing Sweeney Todd
    0:10:59 when he was eight years old.
    0:11:00 Sweeney Todd is a musical by Stephen Sondheim
    0:11:03 about a barber in Victorian England
    0:11:05 who, having suffered a great injustice,
    0:11:08 gets revenge by slaughtering people in his barber shop
    0:11:13 and with the help of his confederate, Mrs. Lovett,
    0:11:16 turning them into meat pies.
    0:11:19 – That play was about a real outsider, a cultural outsider,
    0:11:23 and it was my first time seeing something
    0:11:24 where an outsider, an anti-hero,
    0:11:27 was presented at the center of something.
    0:11:30 The violence of his emotions and the injustice of the world
    0:11:33 was being propounded in these crazy songs
    0:11:36 and in this wild comedy,
    0:11:37 and it was all kind of cross-hatched together.
    0:11:40 That was very thrilling for me,
    0:11:42 and it was showing me something about my psyche
    0:11:44 that I didn’t have the language for,
    0:11:46 ’cause I was too young to know how to speak about my life,
    0:11:49 but he became like an avatar for me.
    0:11:51 He scared me, and he scared me because he was in me already.
    0:11:55 – You mean Sweeney, not Sondheim.
    0:11:56 – Sweeney, and probably Sondheim,
    0:11:59 ’cause I think Sweeney is a part of Sondheim.
    0:12:01 I think all artists have that part to them,
    0:12:03 the exile, the outsider, the person who doesn’t fit in
    0:12:06 that nobody understands and needs to be seen
    0:12:08 and needs to get revenge and needs all these things.
    0:12:10 So I was very taken by that show,
    0:12:13 but I couldn’t understand it, and I have a language for it,
    0:12:15 and it was almost like I was knocked upside my head,
    0:12:18 and I like theater that creates that experience
    0:12:21 for the audience.
    0:12:22 – Sweeney Todd was recently revived on Broadway
    0:12:27 with Josh Groban playing Sweeney for a time
    0:12:30 beside the endlessly entertaining Annaly Ashford
    0:12:33 as Mrs. Love It.
    0:12:35 And there’s another Sondheim revival on Broadway right now,
    0:12:38 merrily we roll along,
    0:12:39 which, like David Ajmi’s Stereophonic,
    0:12:42 may win some Tony Awards.
    0:12:45 But Stephen Sondheim, who died in 2021,
    0:12:48 is more of a theater person’s theater person.
    0:12:51 He did win many awards, and some of his shows,
    0:12:55 like Company and Into the Woods,
    0:12:57 did have long Broadway runs,
    0:12:59 but you have to go back to West Side Story and Gypsy
    0:13:03 to find a time when Sondheim was considered mainstream.
    0:13:06 When you look at the shows that make it to Broadway today,
    0:13:09 especially the musicals,
    0:13:11 most of them are targeted at tourists
    0:13:13 who want a fun and familiar piece of entertainment.
    0:13:17 Not that there’s anything wrong with that,
    0:13:19 but people like Sondheim and now David Ajmi
    0:13:23 have always offered something different,
    0:13:25 something more original, more off-kilter
    0:13:30 than the blander entertainments in the Hollywood adaptations.
    0:13:34 But why isn’t there more of that?
    0:13:37 – There’s no funding for it,
    0:13:38 and people are discouraged to do it
    0:13:40 because they wanna be produced,
    0:13:41 so they think they have to make their work producible,
    0:13:43 so they’re chasing trends,
    0:13:44 and the artistic directors are trying to appease their boards,
    0:13:47 and they’re trying to bring subscribers in,
    0:13:49 and everyone wants something a little middle-brow
    0:13:52 ’cause it’s easier to digest.
    0:13:54 – What Ajmi is talking about here
    0:13:55 are the nonprofit theaters that feed Broadway.
    0:13:58 The theater is in places like Seattle and Chicago,
    0:14:01 La Jolla and Hartford.
    0:14:03 – A writer really has to risk being a splinter.
    0:14:07 Someone who comes in and disrupts,
    0:14:09 and you are not going to make money doing that, probably.
    0:14:12 – Well, you might.
    0:14:13 – Now I can.
    0:14:14 – But like, this is lightning striking.
    0:14:16 This is a rare occurrence.
    0:14:18 – It is, and this play,
    0:14:19 I didn’t try to do this to be commercial or anything like that.
    0:14:22 I made it the same way I make everything else,
    0:14:24 but it has music in it,
    0:14:25 and I’m working with a brilliant composer
    0:14:27 and people like music,
    0:14:28 so it kind of abuts being a Broadway musical,
    0:14:31 even though it has nothing to do with that.
    0:14:32 – The brilliant composer he’s talking about
    0:14:34 is Will Butler from Arcade Fire,
    0:14:37 the Canadian band who’ve made some very good records
    0:14:39 over the past couple of decades.
    0:14:41 His brother, Win Butler, is the frontman.
    0:14:43 He was recently accused of sexual misconduct
    0:14:46 and bullying.
    0:14:48 By then, Will Butler had already quit the band.
    0:14:51 Some of the music he wrote for Stereophonic
    0:14:54 sounds like Arcade Fire.
    0:14:56 It is dark and bright at the same time somehow.
    0:15:00 It is traditional in some key ways, but also modernist.
    0:15:05 But the band that Stereophonic really reminds you of
    0:15:08 is Fleetwood Mac.
    0:15:10 The demographics are identical.
    0:15:12 There is a British husband and wife
    0:15:14 who were in the midst of breaking up
    0:15:16 as were Christine and John McVeigh
    0:15:18 when Fleetwood Mac recorded their blockbuster record rumors.
    0:15:21 There is an American couple,
    0:15:23 very much like Lindsay Buckingham and Stevie Nicks,
    0:15:26 who are also in the middle of breaking up.
    0:15:28 Their names are Peter and Diana in the play.
    0:15:32 If you’re looking for further Fleetwood Mac parallels,
    0:15:34 both Lindsay Buckingham and the Peter character
    0:15:37 happen to have a brother who swims in the Olympics.
    0:15:41 And the fifth member of the Stereophonic band
    0:15:44 is a drummer who is also British, as was Mick Fleetwood.
    0:15:48 The entire play, more than three hours long,
    0:15:51 happens inside a recording studio.
    0:15:53 The band is making their second record.
    0:15:55 They’re first at a slow start, but now it is caught fire
    0:15:59 and they are turning into big rock stars.
    0:16:02 Although that’s all happening outside the studio.
    0:16:04 We feel it, but we never see it.
    0:16:07 We also feel the sudden pressure of huge expectations.
    0:16:12 There are also two recording engineers in the play.
    0:16:15 So seven people hermetically sealed on this stage
    0:16:20 of fishbowl of ambition and talent
    0:16:24 and exhaustion and frustration.
    0:16:26 It is both thrilling and painful
    0:16:29 to so thoroughly eavesdrop on them.
    0:16:32 David Ajmi is in his early fifties
    0:16:35 and he had written several plays before this one,
    0:16:37 but Stereophonic will end up being more commercially successful
    0:16:40 than the rest of them put together, maybe times 10.
    0:16:44 I asked him where the inspiration
    0:16:46 for Stereophonic came from.
    0:16:49 He said it was from listening
    0:16:50 to a Led Zeppelin recording one day.
    0:16:53 – I was on a plane ride and I was going to a conference,
    0:16:56 a theater conference and I was listening to In-Flight Radio
    0:16:59 and that song, “Babe, I’m Gonna Leave You,”
    0:17:01 which is the cover they did, came on.
    0:17:04 – That song was written in the 1950s
    0:17:06 by the folk singer Ann Burdon.
    0:17:08 It was first recorded by Joan Baez
    0:17:10 before Led Zeppelin covered it.
    0:17:12 – My brother, when I was a really little kid,
    0:17:14 my brother’s much older than me.
    0:17:16 He used to play that over and over on his guitar
    0:17:18 when he was teaching himself how to play guitar.
    0:17:20 So I knew that song just from those chords,
    0:17:24 but then I started listening to the vocals
    0:17:27 and it’s just so crazy and so volatile
    0:17:30 and so emotionally intense.
    0:17:33 ♪ I’ve got the power ♪
    0:17:36 There’s something about it was just so transfixing to me.
    0:17:39 ♪ I’ve got the power ♪
    0:17:41 – And I just imagined the studio.
    0:17:43 I was trying to visualize it
    0:17:44 ’cause you’re trapped on a plane, what are you gonna do?
    0:17:47 It activates the imagination and then I sort of went,
    0:17:49 “Oh, wait a minute, what if that’s the set for a play?”
    0:17:53 And I just immediately knew
    0:17:54 that I was gonna write this play and I thought,
    0:17:56 “But how am I gonna write this play?
    0:17:58 “It’s not so interesting.
    0:17:59 “They’re just gonna record an album, what is it?”
    0:18:02 And so I just sort of let myself not know
    0:18:04 for a really long time how I was gonna do it,
    0:18:07 but I just knew sometimes you just kind of know.
    0:18:09 – I think this is the first time I’ve ever heard anybody
    0:18:12 have the genesis of a great piece of art
    0:18:14 come from in-flight radio.
    0:18:16 – Welcome to me.
    0:18:19 – From that day until today is about how many years?
    0:18:23 – That was 11 years ago.
    0:18:24 – Were you working on it during that time
    0:18:27 or did you just let it germinate for a while in your mind?
    0:18:30 – I let it germinate for a while.
    0:18:31 I was doing other things.
    0:18:32 I was supposed to write my book.
    0:18:33 I was late with my book and I had another project
    0:18:35 that I was commissioned to do.
    0:18:36 And so I was doing this like on the side.
    0:18:39 And the way that I decided to make it was,
    0:18:41 I just decided to invite a director to come on
    0:18:45 and invite my composer and invite the music director
    0:18:48 and invite a team.
    0:18:50 Before I had a word on page, I just said,
    0:18:52 “Would you guys all just commit to doing this with me?”
    0:18:55 It became almost like this weird totemic force,
    0:18:58 this kind of weird–
    0:19:00 – Well, you formed a band.
    0:19:02 – I formed a band and we are a band.
    0:19:04 It feels like it.
    0:19:05 – Had you been in a band before?
    0:19:07 – Never ever.
    0:19:09 I knew I wanted to work with Arcade Fire
    0:19:10 from the first time I heard the funeral album.
    0:19:13 And then when I thought about this project
    0:19:14 and just the feeling of the music that I wanted,
    0:19:17 I just thought of them.
    0:19:18 So I had a friend who knew the creative director
    0:19:21 of Arcade Fire, so we reached out to Arcade Fire
    0:19:23 and Will was the only one who came back
    0:19:25 and said, “I’ll meet with you.”
    0:19:26 – Where was he living then?
    0:19:27 – He was living in Montreal right before that,
    0:19:29 but he’d just moved to New York.
    0:19:30 So it was kind of perfect timing.
    0:19:32 We met and we talked about like Herman Melville
    0:19:35 and Moby Dick for a really long time.
    0:19:37 Will’s a polymath and so he’s not a normal rocker.
    0:19:40 He’s really smart, really smart.
    0:19:42 He knows about everything.
    0:19:44 And so I just was like, “This guy’s cool
    0:19:46 and he’s a unicorn.”
    0:19:47 I could tell right away he’s adaptable.
    0:19:50 He can do different kinds of things.
    0:19:51 And I said, “This isn’t gonna be the kind of thing
    0:19:54 where you come in with a song and then we put the song on.
    0:19:56 Like we have to go through iterations.
    0:19:57 It has to be right for this play.
    0:19:59 It has to fit exactly into what I’m doing.
    0:20:01 Are you open to that?”
    0:20:02 And he said, “Absolutely.”
    0:20:03 He was super cool about it.
    0:20:05 And so he agreed to do it in 2014.
    0:20:07 And then I don’t think it was until 2018
    0:20:10 that I had a draft that I could show him.
    0:20:13 And we read it together.
    0:20:15 Will played some parts.
    0:20:16 I played parts Daniel and my music director.
    0:20:19 Yeah, my director and the music director.
    0:20:21 We all kind of read it together a couple of times.
    0:20:23 And then he went home and he read it.
    0:20:25 And then he like built out songs in character.
    0:20:28 – Did he build out many of the songs
    0:20:30 right in that first round of writing
    0:20:31 or did it come slowly?
    0:20:33 – No, he had a couple and then a few that we didn’t use.
    0:20:37 And it went on like that for a while.
    0:20:39 Like Masquerade didn’t have a bridge.
    0:20:40 And I was like, “Dude, that song needs a bridge.
    0:20:43 Can we do this and that?”
    0:20:44 I’d say I want it to be a little more heterogeneous.
    0:20:46 I don’t want it to just have one feeling to it.
    0:20:49 I want it to switch and turn more.
    0:20:50 And I would like dramaturg the songs.
    0:20:52 He let me do it ’cause he was cool like that.
    0:20:55 And when he didn’t want to,
    0:20:56 he wouldn’t and say, “Okay, I’ll shut up.”
    0:20:59 ♪ I might take you to the Masquerade ♪
    0:21:03 ♪ Soul is sold on the money paid ♪
    0:21:06 – I was researching this play by, I mean, I read books,
    0:21:09 but I also watched a ton of documentaries.
    0:21:11 – What were some of the docs
    0:21:12 and what were some of the bands that you watched and liked?
    0:21:15 – So many.
    0:21:16 – I mean, I’m guessing there was a Fleetwood Mac doc.
    0:21:18 – There were definitely Fleetwood Mac docs.
    0:21:20 They have one, I think it’s from when they were making Tusk
    0:21:22 that has a lot of great, very private feeling stuff in it.
    0:21:26 The Metallica documentary, some kind of monster.
    0:21:30 There was something about this documentary style
    0:21:32 and feeling that I myself was watching eavesdropping
    0:21:36 on these people in this very private recording process
    0:21:38 because nobody gets led into these studios.
    0:21:41 So the fact that I was watching them
    0:21:43 and hearing these Soto Votre conversations
    0:21:46 and seeing these private moments.
    0:21:48 – Yeah, but here’s what I like about your show more
    0:21:51 than those docs, which I also like,
    0:21:53 but when you are a musician in a studio
    0:21:55 and there’s a camera, you know, it’s there.
    0:21:58 You may act as if it’s not
    0:21:59 and you might forget about it once in a while,
    0:22:01 but generally you will behave in a way that burnishes
    0:22:05 in your mind your reputation at that moment
    0:22:08 because you understand you’re being observed.
    0:22:11 So it might look like real life, but it’s not really.
    0:22:14 Whereas in your fictional version,
    0:22:17 it feels more like nonfiction
    0:22:19 because you don’t have those constraints.
    0:22:21 It feels like we’re eavesdropping for real.
    0:22:24 Well, thank you for saying that.
    0:22:25 That’s a real compliment to us.
    0:22:27 Whether it’s an illusion or not,
    0:22:29 that was what was so seductive to me
    0:22:30 about those documentaries.
    0:22:32 And so when I was composing the play
    0:22:36 and I wanted to use a different style
    0:22:38 and realism for me as a style,
    0:22:40 I started to sort of borrow from that.
    0:22:42 And that’s why there’s so much overlapping dialogue
    0:22:44 in that first scene.
    0:22:44 I really wanted people to understand like,
    0:22:47 no, you’re not gonna get it all.
    0:22:48 This is not for you.
    0:22:50 You have to lean in from the beginning
    0:22:52 and know you’re gonna miss stuff
    0:22:53 because you’re eavesdropping.
    0:22:55 So that creates the kind of lattice work
    0:22:58 through which you peek in and watch the play
    0:23:00 from the very first scene.
    0:23:01 That was very deliberately constructed.
    0:23:03 – Can you check to see if the mic pre is on?
    0:23:07 – My head is like a brick.
    0:23:09 – It’s on?
    0:23:10 – Grab some aspirin.
    0:23:11 – You don’t need an aspirin.
    0:23:11 I need to get like one hour of sleep.
    0:23:13 This is insane.
    0:23:14 Did you sleep through that?
    0:23:15 – Look at my eyes.
    0:23:17 – Oh, their blood shot.
    0:23:21 – So I used to play music and record music.
    0:23:23 And of many things I love about your play,
    0:23:25 one is simply how well the playing of music is rendered.
    0:23:29 It just feels real and thrilling and painful
    0:23:33 and all those things you feel when you’re in a band.
    0:23:36 But I also loved how well you rendered the recording process,
    0:23:39 which is a totally different animal.
    0:23:41 So can you talk about how you got to that?
    0:23:44 – So much of it was me faking stuff early on.
    0:23:47 I would look at things in documentaries
    0:23:49 and they’d say these phrases and I go,
    0:23:50 “Ooh, that sounds cool.”
    0:23:51 And I’d write it down.
    0:23:52 Just every time a phrase sounded like something cool
    0:23:55 that I would believe sounded like a real production thing,
    0:23:58 I would write it down.
    0:23:59 – Like your snare is rattling a little bit.
    0:24:00 – Well, yeah, and that I got,
    0:24:02 I knew I wanted to be a problem with the drum.
    0:24:05 And I didn’t know what kind of problem
    0:24:07 would happen with the drum.
    0:24:08 So I said to my sound guy, Brian Rumory, who’s brilliant,
    0:24:12 what kind of problem would happen
    0:24:13 that would cause this drummer to melt down?
    0:24:16 And what would he do to fix it?
    0:24:17 And then how could that go wrong?
    0:24:19 I wanted to construct a scene where he goes down a black hole
    0:24:22 as so Ryan really talked me through it for about an hour.
    0:24:25 That’s how I did that scene.
    0:24:26 – Now the snares are ringing again.
    0:24:31 – I didn’t hear it that time.
    0:24:33 Did you hear it?
    0:24:33 – No.
    0:24:34 – I didn’t hear it that time.
    0:24:35 – I wanted to fix it and it keeps making everything worse.
    0:24:38 You know, I wish we hadn’t touched it.
    0:24:39 I really do.
    0:24:40 I really do.
    0:24:41 I wish we just left it alone.
    0:24:42 – Sorry, man.
    0:24:43 – A drum is a piece of wood.
    0:24:48 It’s ephemeral.
    0:24:49 You can’t keep changing things.
    0:24:51 Now we’ve changed everything and I can’t change it back.
    0:24:53 – Stereophonic is about a band.
    0:24:58 And it’s about a band early on in its career
    0:25:01 that’s finding fame.
    0:25:02 They all happen to love each other
    0:25:05 and have relationships with one another.
    0:25:07 I’m Sonia Friedman and I’m a theater producer.
    0:25:11 – Friedman, based in London, is one of the most prolific
    0:25:14 theatrical producers in recent history.
    0:25:16 At the moment, she has more than a dozen shows
    0:25:19 in production on the West End in London,
    0:25:21 as well as on Broadway and in several other countries.
    0:25:24 Her shows have won more than 60 Olivier Awards in Britain
    0:25:28 and as of this recording, 39 Tony Awards.
    0:25:32 I asked Friedman why she’d been attracted to Stereophonic.
    0:25:36 – We watched them through the course of the making of
    0:25:40 an album which will end up being a great album
    0:25:44 for the ages, but they don’t know that at the time.
    0:25:47 Watch them battle through creativity,
    0:25:50 trying to find their own individual voices,
    0:25:52 but also be as one and crash through their relationships
    0:25:58 and see them just battling through.
    0:26:01 And the thing is that what David the author and Daniel,
    0:26:04 the director have done is they’ve been incredibly bold
    0:26:07 with this show because there’s this rule in New York.
    0:26:12 You know, there’s this rule in New York.
    0:26:13 You can’t have shows running over a particular length of time
    0:26:17 and you know, it’s got to have stars in it.
    0:26:20 If you follow a formula for Broadway,
    0:26:23 actually what I’ve found is the biggest successes
    0:26:25 on Broadway tend to break that formula.
    0:26:28 And this is one of those.
    0:26:29 It has to run at three hours plus because you have to get
    0:26:34 this sense of this album taking forever to make.
    0:26:39 And you never, ever, ever feel the length.
    0:26:41 You want to be with this group forever.
    0:26:43 And of course, the music is sublime
    0:26:47 and they’re really brilliant with the way they tease the music.
    0:26:50 They don’t give it to you easily.
    0:26:52 You have to wait, you have to wait.
    0:26:54 But there’s this moment of absolute ecstasy
    0:26:57 when, you know, 45, 50 minutes in, you hear it and you go,
    0:27:00 “Oh God, that’s what they’re making.”
    0:27:02 Oh wow.
    0:27:04 ♪ Never wakes you in the morning ♪
    0:27:10 ♪ Whatever keeps you up at night ♪
    0:27:14 And it sort of begins to make sense as to why this group
    0:27:18 who seem at each other’s throats,
    0:27:20 and then they get in the room together and they make magic.
    0:27:24 And that’s art. That’s art.
    0:27:25 The band in Stereophonic is never named.
    0:27:32 The actors do have a pet name for the band,
    0:27:34 but I promised not to tell.
    0:27:36 They are led by Peter, who writes, sings, plays guitar,
    0:27:40 and winds up imposing his will on everyone else.
    0:27:44 We hear about Peter before we see him.
    0:27:46 Here are Simon, the drummer, and Diana, who writes and sings.
    0:27:51 She’s also Peter’s girlfriend.
    0:27:53 – The last album took three weeks.
    0:27:55 So this can’t take more than another two, three weeks tops.
    0:27:57 We can make it two more weeks.
    0:27:59 – Peter said last night he was ready to snap,
    0:28:01 and he wanted to confront Reg and I said, “No,
    0:28:03 don’t escalate things.”
    0:28:04 – It was good you did that.
    0:28:05 – “And now you have to do your part.”
    0:28:07 – All of the characters are interesting
    0:28:11 and at least occasionally charming,
    0:28:13 except for Peter, who doesn’t do charm.
    0:28:17 – He’s got a very, very difficult role,
    0:28:20 because how I see him, that’s maybe because I’m a producer,
    0:28:24 I see him trying desperately to wrestle this group
    0:28:29 and keep this group together, and he has a vision,
    0:28:33 and maybe he’s got such a strong vision
    0:28:37 that he’s not seeing what’s going on around him.
    0:28:39 – Peter is one of the lead vocalists in the band.
    0:28:43 He’s the lead guitarist of the band
    0:28:46 and becomes the producer of the album as the show goes on.
    0:28:50 I’m Tom Fasinka and I’m an actor.
    0:28:54 – How would you describe the Peter character emotionally?
    0:28:58 – He’s a control freak, but there’s reasons why.
    0:29:02 He’s a guy that is a survivor in a lot of aspects.
    0:29:06 I won’t go into all the backstory of his father
    0:29:09 and all that stuff, ’cause I think that’s sort of for me.
    0:29:12 – Some of it’s in the writing.
    0:29:13 – Some of it’s in the writing,
    0:29:14 but I think the emotional landscape is for me.
    0:29:18 I think he’s been taught a certain amount of savagery.
    0:29:22 He’s had to develop a work ethic that can be harmful
    0:29:27 to himself and to others, but can also produce great results.
    0:29:31 – What does it feel like to play this character?
    0:29:33 Forget about the endurance requirements of a three hour show.
    0:29:37 I mean, you’re on stage, everyone’s on stage a lot,
    0:29:40 but what’s the experience feel like?
    0:29:43 – This show has been an incredible experience
    0:29:47 and a challenging one in the fact
    0:29:49 that my character is not the most palatable person in the room.
    0:29:53 So, you know, I’ve been heckled.
    0:29:56 There’s loud groans of disapproval.
    0:29:59 I always used to say that,
    0:30:01 oh, I’m an actor who doesn’t care if he’s liked or not.
    0:30:03 That’s not what an artist cares about.
    0:30:06 But I think deep down, as human beings,
    0:30:08 we all care if we’re liked even a little bit.
    0:30:11 So I think the universe brought this play into my life
    0:30:14 to sort of be like, yeah, prove it.
    0:30:16 – What’s a line in Stereophonic that you know
    0:30:20 that every night you say it,
    0:30:21 you’re going to become the objective scorn?
    0:30:25 – No, she asks me, can I speak with you privately?
    0:30:29 Can I say no?
    0:30:31 And before that, I say,
    0:30:33 then don’t get in your own head, be a professional.
    0:30:36 So those are two guaranteed groans from the audience.
    0:30:41 – I think you romanticize who you are a little bit.
    0:30:45 You’re looking out for yourself just as much as I do.
    0:30:48 You’re very ambitious.
    0:30:49 – I am not ambitious.
    0:30:51 Don’t sling mud at me.
    0:30:52 – You want to use me to arrange a song,
    0:30:53 but then when I’m telling you it’s too long
    0:30:55 or to cut something, you have no interest.
    0:30:56 And then you take it as criticism.
    0:30:58 Then don’t ask me to arrange a song.
    0:30:59 – Because you can be very aggressive, Peter.
    0:31:01 – How am I?
    0:31:01 – I don’t like to be forced.
    0:31:02 Okay?
    0:31:03 He says some pretty out of pocket stuff.
    0:31:07 I’m Sarah Pigeon, I’m an actor
    0:31:11 and I’m currently in Stereophonic playing Diana.
    0:31:14 He also says, if I don’t force you to have a baby,
    0:31:18 then it’s never going to happen.
    0:31:19 It’s like, oh, you don’t say that.
    0:31:22 – Is it hard for you as a female actor in 2024
    0:31:25 to get into that mode in 1976 and 1977
    0:31:29 where those things were said by a man
    0:31:32 and not respond the way you might want to respond in 2024?
    0:31:35 – Yeah, I think that was one of the more difficult hurdles
    0:31:39 that I had to get over.
    0:31:40 I was judging Diana a lot at the beginning
    0:31:43 for staying in this relationship.
    0:31:45 And I was bringing my 2024 self to it.
    0:31:49 Like a guy just should not talk to you that way.
    0:31:51 And how have you stayed in it for this long?
    0:31:53 But she doesn’t know what feminism is.
    0:31:55 She doesn’t know who Gloria Steinem is.
    0:31:57 She knows she has these feelings.
    0:32:00 It’s a time in I think rock history
    0:32:02 where there’s no one to look to for direction and guidance.
    0:32:06 I don’t think that there’s this feeling
    0:32:07 that she can go off on her own.
    0:32:09 I don’t even think it crosses her mind
    0:32:10 until she’s offered a solo album.
    0:32:12 I think her understanding of her artistry
    0:32:15 and songwriting is so tied to Peter’s orchestration of it
    0:32:20 and his editing and his advice.
    0:32:23 – Here is David Ajmi again,
    0:32:25 talking about the Peter character.
    0:32:27 – That character is very similar to me in a lot of ways.
    0:32:30 He’s very damaged and that’s a lot of my damage.
    0:32:34 It’s all kind of this weird cross-hatching,
    0:32:36 but in the end it’s a self portrait.
    0:32:38 And I think all great art has to be that.
    0:32:39 You have to put skin in the game.
    0:32:40 You can’t just write about those people over there.
    0:32:44 They have to be inside of you in some way for it to really work.
    0:32:47 – What I love about Peter,
    0:32:48 even though he’s sort of odious sometimes,
    0:32:51 is that he sets the bar really high
    0:32:54 and that pisses everyone off,
    0:32:56 but they’re also grateful for it in the end.
    0:32:59 How much of that is you?
    0:33:01 – That’s me, it’s all me.
    0:33:02 – Remind me not to collaborate with you.
    0:33:05 – I just maintain and I’ve said it over and over
    0:33:07 to the cast ’cause I’m a big staunch defender of Peter,
    0:33:10 even though I know he’s got a lot of problems.
    0:33:13 Peter’s biggest flaw is that he has no bedside manner.
    0:33:15 He doesn’t understand how to be politic
    0:33:18 about offering his criticism and he has bad timing.
    0:33:21 If he just could be more gracious and more kind of tricky
    0:33:24 about how to deliver these criticisms
    0:33:26 and he could lie better, but he’s not a liar.
    0:33:29 He’s really, really blunt.
    0:33:31 And it’s part of an ethos that makes him great,
    0:33:35 even though it’s really annoying
    0:33:36 and it’s hard to work with somebody
    0:33:38 who doesn’t attend in a sensitive way to your feelings.
    0:33:42 When this process is so, everything is so charged
    0:33:45 and heightened, you need to be sensitive to people.
    0:33:48 You can’t just deliver these like sledgehammer criticisms,
    0:33:52 but he’s right a lot of the time.
    0:33:53 And in the play, you see how he’s right.
    0:33:56 And it drives everybody crazy that he’s right,
    0:33:58 but I don’t judge my characters.
    0:34:00 I think Peter is sexist because he grew up
    0:34:03 in a sexist culture and it was 1976.
    0:34:06 I don’t think he’s a bad guy.
    0:34:08 I think he’s living in a kind of weird soup of the time.
    0:34:14 It was sort of a tight wire act
    0:34:15 because I really don’t want people to turn against Peter.
    0:34:19 They do, no matter what I do.
    0:34:20 I mean, they do and they don’t like him, but I love him.
    0:34:25 – Were you tempted to rewrite to make him
    0:34:27 a little bit more likable at least in moments?
    0:34:29 – No, Tom Pysenko who plays Peter is really adamant
    0:34:33 that we stay true to the character.
    0:34:36 He is a hardcore man.
    0:34:37 I just love that guy because it comes from an ethical spine.
    0:34:41 He’s like, my job is not to make you love him.
    0:34:43 My job is to show you who this person is
    0:34:47 and to show him in as much dimensionality as I can.
    0:34:51 And he does that beautifully.
    0:34:53 – I love that he said I have an ethical spine
    0:34:57 because I think I do as an artist.
    0:34:59 Like I have strong artistic values and I don’t care
    0:35:04 ’cause it’s not me.
    0:35:08 I don’t know if it’s like because we live in the age
    0:35:10 of social media or we live in the age of reality television,
    0:35:13 people just assume that, oh, well,
    0:35:16 you must be like your character and it gets to you.
    0:35:19 Off-Broadway, someone was like, I hated you or I hate you.
    0:35:23 And I was like, you hate me?
    0:35:24 That’s insane.
    0:35:26 It’s not my job to make people like Peter.
    0:35:28 It’s my job to make people see Peter
    0:35:31 and be in the room with him, which a lot of people don’t like.
    0:35:34 And maybe it’s because I’m a bit of a contrarian
    0:35:38 or I’m a bit of like a, I don’t know.
    0:35:40 I don’t even know what the right word is,
    0:35:42 rebel or something.
    0:35:43 But part of me loves it, part of me loves it
    0:35:47 because it’s like you are throwing all your manners
    0:35:50 out the window as an audience member to jeer at me.
    0:35:54 I’m triggering something in you that’s real.
    0:35:56 – We’ve been told throughout this show
    0:36:00 to have a bit of hostility to the audience.
    0:36:02 – By whom? Your director?
    0:36:03 – Our director, yeah, Daniel Ockett.
    0:36:05 There’s a lot of laughs in the show
    0:36:07 and there’s moments and beats and pauses
    0:36:09 and there’s a lot of musicality outside of the music
    0:36:12 just in David’s writing.
    0:36:13 The hostility is in the sense of not allowing
    0:36:17 the audience’s reaction to throw us off
    0:36:20 the rhythm and tempo that we’re exploring in the show.
    0:36:23 – Coming up after the break,
    0:36:27 how did that rhythm and tempo, those beats and pauses
    0:36:32 turn into such a big hit?
    0:36:35 I’m Stephen Dubner.
    0:36:36 This is Freakin’omics Radio.
    0:36:37 We’ll be right back.
    0:36:39 (upbeat music)
    0:36:42 – David Ajmi was originally given a commission
    0:36:49 to write Stereophonic by two nonprofit theater companies,
    0:36:53 second stage in New York
    0:36:55 and center theater group in Los Angeles.
    0:36:58 – It was a co-commission from the two of them.
    0:36:59 So they paid me for the commission,
    0:37:01 but I mean over the course of 10 years,
    0:37:03 if you divided what I got paid,
    0:37:05 it’s, you know, you get more working at McDonald’s.
    0:37:07 – Would you get paid for the commission?
    0:37:09 – I think I got something like 30 grand.
    0:37:11 – What did you do with all that money over those 10 years?
    0:37:13 – I survived.
    0:37:14 I mean, I paid my credit card bills.
    0:37:15 This is what you have to do.
    0:37:17 – It does strike me that committing to a life
    0:37:19 in the theater, as you did pretty early,
    0:37:22 and as many people still do,
    0:37:24 is essentially a commitment to poverty and struggle as well.
    0:37:29 – Oh yeah.
    0:37:30 – I mean, what’s happening now with you is an anomaly
    0:37:32 and it’s a great break and I’m so, so happy for you.
    0:37:36 But can you just talk about,
    0:37:37 not only for all the other writers,
    0:37:39 but the performers and everybody else
    0:37:41 that goes into making these things that, you know,
    0:37:44 we just show up and sit down in the seat.
    0:37:47 Can you just talk about what that kind of commitment
    0:37:49 is like to a life like that?
    0:37:51 – Thank you for asking that question.
    0:37:53 Look, I was able to write this play
    0:37:55 because I had patrons essentially.
    0:37:58 There were two architects, very wonderful,
    0:38:00 well-known architects living in the Hollywood Hills,
    0:38:03 who had a floor of their home and I hooked up with them
    0:38:05 and they let me live in that floor.
    0:38:07 I lived there for about seven years,
    0:38:09 gratis, and I did a little bit of TV work,
    0:38:12 but basically not that much.
    0:38:14 That’s how this play was written
    0:38:16 because of their generosity.
    0:38:17 – There are people who argue
    0:38:20 that the government should just support the arts more.
    0:38:23 They argue there’s a compelling rationale for that,
    0:38:26 et cetera, and many other countries,
    0:38:27 especially in Europe, do that.
    0:38:28 What’s your position there?
    0:38:29 – Yes, I absolutely agree with that.
    0:38:31 I think it’s obscene that we don’t fund our artists.
    0:38:34 It’s the hallmark of a civilized society.
    0:38:36 Paula Vogel told me that in 1975,
    0:38:39 she got a grant from the NEA,
    0:38:40 which at that point funded individual artists
    0:38:43 before Trent Lott and the moral majority
    0:38:44 got involved in the ’90s.
    0:38:46 And she got $25,000,
    0:38:47 which was enough to live on for a year at that point,
    0:38:50 and she was able to kickstart her career.
    0:38:52 I was fortunate ’cause I ended up getting private grants.
    0:38:55 Like I was at one point locked in a job
    0:38:58 as a paralegal in “30 Rock,”
    0:39:00 and I was working all day and I had no time to write.
    0:39:03 I was like, “I’m never gonna be able to be a writer.”
    0:39:06 I don’t know how to eat cattle living.
    0:39:07 And I got this miraculous call
    0:39:10 saying that I won a grant for $25,000 in 2003, I think it was.
    0:39:14 And I thought, “Well, I can really make this last
    0:39:16 if I move to Germany.”
    0:39:16 So I moved to Berlin.
    0:39:18 I lived in Prince Lauerberg,
    0:39:19 which is a gorgeous neighborhood.
    0:39:20 It’s like the West Village.
    0:39:22 My rent was $200 a month.
    0:39:23 That’s how I generated the beginning
    0:39:26 of my body of work that made my name.
    0:39:28 – Ajmi wrote plays that ran off-Broadway
    0:39:33 at regional theaters, at the Royal Court Theater in London.
    0:39:37 It was a relatively successful career for a playwright.
    0:39:41 So what was his thinking before writing “Stereophonic”?
    0:39:46 – Ironically, I was sort of planning
    0:39:47 to quit plays altogether.
    0:39:50 I had a very bad collaboration,
    0:39:52 actually a really torturous collaboration.
    0:39:56 I made no money from the production
    0:39:57 and I was so beaten up.
    0:39:58 I thought, “I’m not gonna do this anymore.”
    0:39:59 – What was that, if you don’t mind me asking?
    0:40:01 – That was a play that went sideways.
    0:40:03 I’m not gonna talk about too much,
    0:40:04 but it was a play about the composer, Oskar Levant.
    0:40:06 So it was another play about music,
    0:40:07 but a very different kind of play.
    0:40:08 – And the producers were regular, standard,
    0:40:11 Broadway commercial producers who liked your stuff?
    0:40:13 – Yes, but they came with an actor attached.
    0:40:16 We talked a little bit and I came up with this idea
    0:40:19 and thought, “Oh, what about Oskar Levant?”
    0:40:21 Then I said, “Okay, I’ll write this play.”
    0:40:23 But you know, they had deadlines,
    0:40:25 all you have to do by this time and stuff.
    0:40:26 It was a little more stringent
    0:40:27 because it was a commercial theater apparatus.
    0:40:29 – So this was a commercial production
    0:40:31 from the outset, correct?
    0:40:32 – Yes.
    0:40:33 – What kind of house or theater
    0:40:34 would it have gone into initially if it had worked out?
    0:40:37 – Broadway.
    0:40:38 – Straight to Broadway?
    0:40:38 – Yeah.
    0:40:39 – I mean, that almost never happens, does it?
    0:40:41 – When Broadway producers commission you
    0:40:43 and there’s a star attached, then yeah, you can do it.
    0:40:45 – I see.
    0:40:46 So it was really about the star here?
    0:40:48 – Yeah.
    0:40:49 – Because then you’re guaranteed whatever,
    0:40:50 24 weeks of box office.
    0:40:52 – Exactly.
    0:40:53 – Otherwise, you’re guaranteed like nothing.
    0:40:55 – Yeah, exactly.
    0:40:56 If there’s no star attached, you’re not gonna do this.
    0:40:58 – Okay, so when that fell apart
    0:41:00 and you were thinking about quitting the theater,
    0:41:02 were you willing to go back to your paralegal career?
    0:41:05 – No, I was gonna do TV.
    0:41:07 That’s why I moved to LA.
    0:41:08 And then they sucked me back in
    0:41:10 ’cause I got this commission for the Broadway people
    0:41:12 and then I got a grant.
    0:41:14 It was a three year grant from the Mellon Foundation.
    0:41:17 And they said, well, you have to write a play
    0:41:19 as part of the grant.
    0:41:20 And I thought, okay, well, I’ll do it,
    0:41:22 but I’ll do like a one act play.
    0:41:23 And I thought that’s what this play was gonna be.
    0:41:25 My one act short little throw away play.
    0:41:28 – And instead it’s like three hours and 15 minutes.
    0:41:30 – It just grew and grew.
    0:41:31 – You have no self control, do you?
    0:41:33 – No, but you know, as I started researching it,
    0:41:35 I realized, oh, I can never leave the theater.
    0:41:37 The play became about me wanting to leave the theater
    0:41:40 and knowing I couldn’t ever leave it.
    0:41:42 Babe, I’m gonna leave you.
    0:41:44 – So, Edgeby didn’t quit.
    0:41:48 He kept grinding away on Stereophonic
    0:41:50 thanks to a free place to live
    0:41:52 and a commission from those two nonprofit theaters.
    0:41:56 – During COVID, everything just fell apart.
    0:41:58 And we went through various iterations
    0:42:01 of potential commercial producers,
    0:42:02 but then they all fell apart.
    0:42:04 And then my agent sent it to all these
    0:42:06 nonprofit theaters in New York
    0:42:07 and everyone said they didn’t wanna do it.
    0:42:09 – Is that because it was tainted
    0:42:10 from the falling apart or no?
    0:42:12 – I don’t think so.
    0:42:13 You know, it’s not a very fashionable play.
    0:42:15 It doesn’t have to do with identity politics.
    0:42:17 It wasn’t really of the moment at all.
    0:42:19 It takes place in 1976.
    0:42:21 It doesn’t have a particular agenda.
    0:42:23 And so I think they were like,
    0:42:24 well, why would we do this?
    0:42:25 And it’s expansive and who cares?
    0:42:27 – And long.
    0:42:28 – Yeah, and it’s long and maybe they didn’t even read it.
    0:42:30 I don’t know who knows why.
    0:42:32 And I knew Adam Greenfield,
    0:42:34 the Artistic Director of Playwrights Horizons for decades
    0:42:37 because he produced my first play in Seattle a long time ago.
    0:42:41 So I said, can we go back to Adam?
    0:42:42 We’d gone to him initially like a year or two before
    0:42:45 and he said, no, no, I have too many plays backed up
    0:42:47 because of COVID.
    0:42:48 I can’t think about this.
    0:42:49 But when we came back to him, he said, listen,
    0:42:51 this is really expensive.
    0:42:53 Tell us what you feel you need to produce this properly
    0:42:57 ’cause this is gonna be a big production.
    0:42:59 And my director and I said, this is how I think
    0:43:01 we need to do this.
    0:43:03 We’re gonna need a soundproof booth
    0:43:04 and we’re gonna need a functioning recording studio
    0:43:06 where we’re gonna probably need music lessons
    0:43:07 for the actors and we’re gonna need more rehearsal time.
    0:43:10 And he said, okay, if I can get the money, I will do it.
    0:43:13 And a few months later, he called back and said,
    0:43:15 okay, I have the money, let’s do it.
    0:43:17 – How much was it?
    0:43:17 – It definitely cost over a million.
    0:43:19 – Wow, for Off-Broadway, that’s a lot.
    0:43:21 – Ours is the second most expensive thing they’ve ever done.
    0:43:24 And they had to sort of rejigger the season
    0:43:26 to accommodate the play.
    0:43:28 But that’s how much he believed in it.
    0:43:31 – Here again is Tom Pesinka, who would be cast as Peter.
    0:43:35 – There are many workshops
    0:43:36 and some of our casts had been part of those.
    0:43:39 I was not part of any of the workshops.
    0:43:40 I just got a cold audition to audition
    0:43:42 to play Reg and Grover.
    0:43:44 – Reg is the bass player, Grover is the main engineer,
    0:43:46 correct?
    0:43:47 – Yes, and then I got called into the room for a callback,
    0:43:51 an in-person callback for the entire team.
    0:43:54 Apparently, I sucked the air out of the room.
    0:43:57 This like legendary audition that I can barely remember.
    0:44:00 – Meaning you brought something to Peter
    0:44:03 that is similar to what Peter is now?
    0:44:05 – Yes, when you’re doing it, you don’t know.
    0:44:07 And I felt like it was great.
    0:44:09 I definitely embraced the connections
    0:44:13 between myself and Peter in a way that I don’t know
    0:44:15 if I had ever done in an audition.
    0:44:17 So I could feel that for sure.
    0:44:20 You never know if it’s gonna make an impact
    0:44:21 or you never know if like the stone cold faces behind the…
    0:44:25 I mean, I do remember David Ajmi nodding furiously.
    0:44:29 So I was like, okay, well, maybe that is good.
    0:44:32 But other than that, no.
    0:44:34 Then I got some messages from my reps being like,
    0:44:37 they want you, you were the best actor in the room,
    0:44:40 but you need to play guitar way better.
    0:44:44 I played sort of garbage guitar
    0:44:46 and I had to really up my game.
    0:44:48 Then they put me in guitar lessons twice a week
    0:44:50 for two months and I had to send them video updates every week.
    0:44:55 And then I was down in DC with my girlfriend.
    0:44:58 She was doing a show at the studio theater.
    0:45:00 I thought it was done.
    0:45:01 I thought, you know, they were ready to make a decision.
    0:45:03 And then my manager called me and said,
    0:45:05 they want one more tape.
    0:45:06 And I almost jumped off the balcony in frustration.
    0:45:10 And then I went to a guitar center
    0:45:12 ’cause I didn’t have a guitar with me.
    0:45:15 I bought a guitar.
    0:45:16 I was gonna return it.
    0:45:17 And then I got the part.
    0:45:19 That guitar now is in my dressing room
    0:45:20 with the Golden Theater.
    0:45:22 I think so many actors are like frustrated rock stars.
    0:45:25 Like they want to be a rock star.
    0:45:26 I knew I did because rock stars have their own character
    0:45:30 and you’re adored.
    0:45:32 And I think it taps into that thing when you’re little
    0:45:34 and you do the first play and you hear that applause
    0:45:38 and like you get addicted to it.
    0:45:40 In order to have a career,
    0:45:42 you have to sort of get past that at some point.
    0:45:45 Being in a band and making music
    0:45:48 and creating something live every night
    0:45:50 is so incredible.
    0:45:53 It’s like a mainline into your veins of just like artistry.
    0:45:57 It can be also really nerve wracking.
    0:45:59 Just like, oh, what if I mess up
    0:46:00 or what if I sing the wrong line?
    0:46:02 The first month, most of the rehearsal day
    0:46:05 was just making the music
    0:46:06 and learning how to play the music.
    0:46:08 I think the direct results
    0:46:10 and I think you see it in the play
    0:46:12 is like we know each other as an acting company
    0:46:15 so much better than probably any acting company
    0:46:18 because we have to rely on each other
    0:46:21 and we have to trust each other
    0:46:22 that like the songs are gonna sound good.
    0:46:25 It’s a build.
    0:46:26 ♪ I feel it once again ♪
    0:46:30 ♪ I feel it once again ♪
    0:46:34 – Here is Sarah Pigeon again, who plays Diana.
    0:46:37 – Off Broadway, the fights were not as equal.
    0:46:40 We’re coming up on like nine,
    0:46:43 maybe 10 months of knowing each other.
    0:46:45 We know each other better
    0:46:46 so there’s this sort of push and pull
    0:46:48 that feels more reflective of an actual relationship.
    0:46:52 There is a certain amount of intimacy and trust
    0:46:55 and knowing of each other
    0:46:58 that was different from when we started in August.
    0:47:00 We were sort of playing at this idea
    0:47:01 of like having been in a relationship
    0:47:03 with someone for nine years.
    0:47:05 Like, well, I haven’t known Thomas Inka for nine years.
    0:47:08 – Familiarity goes two ways.
    0:47:10 Familiarity is like lovely,
    0:47:12 but you can hurt someone more.
    0:47:14 – Right, you know how to hurt them.
    0:47:17 – You know how to push their buttons.
    0:47:18 You know how to like unravel the thread
    0:47:20 like Diana says in the play.
    0:47:22 I mean, they would never say it,
    0:47:24 but like I know Sarah and Juliana were pissed with me
    0:47:27 certain times when like I got the harmonies wrong
    0:47:30 or like when I was so nervous playing masquerade
    0:47:33 that I would like drop out of the song.
    0:47:34 Juliana would have to pick up the slack.
    0:47:37 We never talked about it,
    0:47:38 but like, you know, I get it, I get it.
    0:47:42 And same way for me, like when they were getting on me
    0:47:44 about the harmonies, I was pissed off,
    0:47:46 but like it’s all love, you know?
    0:47:49 It’s like, it is.
    0:47:50 I mean, it’s so cliche, but it’s like, it is family.
    0:47:53 It’s family.
    0:47:54 – So at the non-profit off-Broadway theater
    0:47:58 Playwrights Horizons, the band was coming together.
    0:48:02 During previews of the play, Word of Mouth started to build.
    0:48:06 Would stereophonic become one of the rare shows
    0:48:09 that make it through the non-profit farm system
    0:48:12 and onto Broadway?
    0:48:13 Here is David Ajmi again.
    0:48:15 – We talked to a bunch of commercial producers,
    0:48:17 but it never fully congealed.
    0:48:19 Either I was having misgivings or they had misgivings
    0:48:22 or they wanted to make changes or whatever.
    0:48:24 And then there was another commercial producer
    0:48:26 that was at one point attached at Playwrights Horizons,
    0:48:29 but then in the middle of the audition process,
    0:48:32 that fell apart.
    0:48:33 – And then the show opened at Playwrights Horizons
    0:48:36 and the reviews were very enthusiastic.
    0:48:41 – And then they all started coming.
    0:48:42 Like one commercial producer would talk to another
    0:48:44 and then they slowly started.
    0:48:46 I had no idea how this all worked
    0:48:47 ’cause I had never done anything commercially before.
    0:48:49 I thought it would be like,
    0:48:51 the different commercial producers come
    0:48:53 and then you interviewed them.
    0:48:55 You know, like, why should I let you commercially produces?
    0:48:59 But instead it was more like they formed a cartel
    0:49:01 and then some got kicked out and some congealed.
    0:49:04 And then we met the leader of the cartel.
    0:49:06 – The cartel actually had a few leaders.
    0:49:11 After the break, we hear from two of them.
    0:49:13 I’m Stephen Dubner.
    0:49:14 This is Freakonomics Radio.
    0:49:16 We’ll be right back.
    0:49:17 (upbeat music)
    0:49:26 – John Johnson is one of the lead producers on Stereophonic
    0:49:31 and he has produced many other shows on and off Broadway
    0:49:34 over more than a decade.
    0:49:35 Along with his business partner, Sue Wagner,
    0:49:38 he is half of Wagner Johnson Productions.
    0:49:41 They act as both producer and general manager.
    0:49:45 This hybrid business model is common in London
    0:49:48 and used to be common on Broadway
    0:49:49 but is much less so today.
    0:49:52 Let’s start with this.
    0:49:53 What does a producer do?
    0:49:55 – So the pure producer side is from, you know,
    0:49:58 conception of the show,
    0:50:00 either commissioning a writer to write a play or musical
    0:50:03 or getting the rights to a play or musical to revive
    0:50:07 all the way to assembling the creative team around that,
    0:50:10 to the raising of the money,
    0:50:13 to the marketing of the show, to securing a building.
    0:50:16 That is the job of the producer.
    0:50:19 If each Broadway show and each off Broadway show
    0:50:21 is essentially an individual small business,
    0:50:24 they are the CEO of said small business.
    0:50:27 – Okay, and what does the general manager do?
    0:50:30 – The GM is the person that does the contracts,
    0:50:33 does the budgeting, does the day-to-day operations,
    0:50:37 hires the staff surrounding the show.
    0:50:40 And the producer is involved in that and advises on that,
    0:50:44 again, using the small business kind of analogy,
    0:50:46 both the CFO and a COO sort of combination.
    0:50:49 – So how did John Johnson become co-CEO, CFO
    0:50:54 and COO of Stereophonic?
    0:50:57 – Remember, when the show premiered off Broadway
    0:51:00 at Playwrights Horizons,
    0:51:01 it had no commercial producers attached.
    0:51:04 – Sue went the first week of previews
    0:51:06 and absolutely lost her mind,
    0:51:08 called me and said, you have to go see this play.
    0:51:11 – Did you lose your mind too?
    0:51:12 – I went after it opened.
    0:51:14 So I go after my partner sets the bar a certain level high,
    0:51:18 then the reviews come out and the reviews are transcendent
    0:51:21 and it sets another level high and I went
    0:51:23 and it cleared both those bars.
    0:51:25 – What month and year are we talking about now?
    0:51:27 – We’re talking November, 2023.
    0:51:30 – Okay, so the COVID shutdown was over by now
    0:51:33 and business was returning to Broadway,
    0:51:35 but the overall numbers were still way down
    0:51:38 and costs had risen a ton during COVID.
    0:51:42 And from what I understand,
    0:51:43 all the theaters were already full, yeah?
    0:51:47 – At the time, there were no buildings available on Broadway.
    0:51:49 There was another show that was not announced for the Golden,
    0:51:52 but everyone kind of knew like,
    0:51:53 “Oh, that’s what’s going into the Golden in the spring.”
    0:51:56 – The John Golden Theater is one of the smallest on Broadway
    0:52:02 with roughly 770 seats.
    0:52:04 It is owned by the Schubert organization,
    0:52:07 the biggest landlord on Broadway.
    0:52:09 Their CEO is named Bob Wankle.
    0:52:11 There is a famous old saying about Broadway economics.
    0:52:15 You can’t make a living, but you can make a killing.
    0:52:19 What’s that mean?
    0:52:21 Most people in the theater work very hard
    0:52:23 for relatively low pay.
    0:52:25 If, however, you are involved in creating a hit,
    0:52:29 something that plays for years and lives on
    0:52:32 in touring companies, maybe a film, you will make millions,
    0:52:36 but that’s rare.
    0:52:38 The best way to make a killing is to be a landlord.
    0:52:43 The Broadway business is, to a large degree,
    0:52:45 a real estate business with a handful of owners
    0:52:48 controlling the vast majority of theater space.
    0:52:51 – We had gotten the show on the radar
    0:52:53 of the Schubert organization.
    0:52:54 We had heard there was the potential
    0:52:56 of the Golden being available.
    0:52:58 And at the time, Bob Wankle had given it to Sonya Friedman,
    0:53:01 who’s a legendary producer in London,
    0:53:03 as well as in New York.
    0:53:05 I was in London and I went to Sonya and I said,
    0:53:07 “Are you going to do this other play at the Golden?”
    0:53:10 And she said, “I can’t fit it in the Golden.
    0:53:11 I need it to go somewhere else.”
    0:53:12 And I said, “Well, we want to do it for Stereophonic.”
    0:53:15 And she said, “Well, I need to do it with you.”
    0:53:16 And at the time, she was opening Stranger Things
    0:53:18 on the West End.
    0:53:19 She had not been in New York in weeks.
    0:53:20 And I said, “Well, you haven’t seen the play yet.”
    0:53:21 She said, “I don’t care.
    0:53:22 Everyone I know who’s seen has loved it.
    0:53:24 I need to be a part of it.”
    0:53:25 – That is a first for me.
    0:53:28 I have never been involved with a show before
    0:53:30 that I pitched myself heavily to produce
    0:53:32 that I hadn’t actually seen.
    0:53:34 I’d read it, but I was in London when it opened
    0:53:36 and I couldn’t get there.
    0:53:37 – And by early December, we stood on stage
    0:53:40 and told the cast that we were moving it to Broadway.
    0:53:42 – What was that like?
    0:53:43 – It was incredible.
    0:53:44 I mean, for six out of seven of them
    0:53:46 to find out they were going to make their Broadway debut
    0:53:47 was amazing.
    0:53:49 This is a playbook that we’ve run before.
    0:53:51 Here’s the hot play of the fall
    0:53:53 and we’re gonna take that momentum from the fall,
    0:53:55 find a building for it in the spring
    0:53:57 and run the awards playbook
    0:54:00 as well as the prestige playbook
    0:54:02 to have it catch on with a newer and larger audience.
    0:54:05 – Tell me a little bit about your investors on this show
    0:54:08 and the capitalization of the show on Broadway,
    0:54:10 how it compares to other things you’ve done.
    0:54:12 – It was demand unlike anything that we’ve seen
    0:54:15 post-pandemic in terms of folks wanting to get in.
    0:54:17 – Meaning it had to turn people away?
    0:54:19 – Yeah, we absolutely to turn people away.
    0:54:20 – What was the minimum investment you accepted?
    0:54:23 – 25,000.
    0:54:24 – I mean, traditionally that’s really small.
    0:54:26 Producers didn’t used to do that kind of thing very much,
    0:54:28 did they?
    0:54:29 – Yeah, and there were some people who wrote
    0:54:30 $150,000 checks or more
    0:54:32 and then there were others who would bundle $25,000 units
    0:54:36 to come up with a larger.
    0:54:37 But again, our capitalization
    0:54:38 because we were taking the production from playwrights
    0:54:41 was capitalized at 4.8 million.
    0:54:43 We spent less than that.
    0:54:45 You wanna build in a certain amount of reserve
    0:54:47 because we didn’t know how I was gonna sell at the beginning.
    0:54:49 We were lucky enough to break even
    0:54:50 in those first couple of weeks,
    0:54:51 but having a little bit of a cover if it had not
    0:54:53 was something we wanted to build in.
    0:54:55 – Here’s a line from the New York Times review
    0:54:57 when it opened on Broadway.
    0:54:59 The play is a staggering achievement
    0:55:01 and already feels like a must see American classic.
    0:55:04 Where were you when you read this?
    0:55:06 Who were you with and how did it make you feel?
    0:55:08 – I was with Greg Noble and Sonia Friedman
    0:55:10 in the press room at our opening night party.
    0:55:12 The review came out, we opened it,
    0:55:14 we read that first paragraph and we all looked at each other
    0:55:16 and said, “Wow.”
    0:55:18 – So let me just ask you now several weeks
    0:55:20 into this run that is very successful
    0:55:23 and looks to be even more successful,
    0:55:25 especially if you win a boatload of Tonys.
    0:55:28 Do you wish in a perfect world
    0:55:30 you would put it into a bigger theater than the Golden?
    0:55:32 – No.
    0:55:33 – Because why not?
    0:55:34 – Because it’s the perfect fit.
    0:55:37 It has this way of wrapping its arms around a play
    0:55:39 and making it intimate.
    0:55:41 As with all shows, plays and musicals,
    0:55:44 finding the right fit of building
    0:55:45 and sometimes you don’t get a choice,
    0:55:46 but this is where the timing worked out in this way
    0:55:49 because it could have easily been,
    0:55:50 “Oh, well, we don’t have the Golden or the Booth available,
    0:55:52 “but we have this 1,100 seat theater available
    0:55:54 “with a second balcony.”
    0:55:56 And I don’t know necessarily
    0:55:57 if it would have had the same reaction.
    0:56:00 – On Broadway, as elsewhere,
    0:56:04 awards drive ticket sales
    0:56:07 and Stereophonic is nominated for 13 Tony Awards.
    0:56:11 It can’t possibly win that many
    0:56:13 since some categories contain multiple Stereophonic nominees.
    0:56:17 Tom Pesinka, for instance,
    0:56:19 is nominated for Best Actor in a Featured Role in a Play
    0:56:23 along with two other male actors in Stereophonic.
    0:56:27 Will Brill, who plays Reg, the band’s bassist,
    0:56:30 and Eli Gelb, who plays the recording engineer Grover.
    0:56:33 I asked Pesinka what it’s like
    0:56:35 to compete in the same category against his castmates.
    0:56:40 – It’s awesome.
    0:56:42 I’m like a super competitive person
    0:56:44 and super ambitious person.
    0:56:46 That’s why I think I can play Peter
    0:56:48 ’cause I definitely have had many years of therapy
    0:56:51 that have brought me to this place,
    0:56:53 but deep down in my heart, I just wanna win.
    0:56:56 The morning of the nominations,
    0:57:00 I got a text from Will Brill that said, “Man you.”
    0:57:05 And that’s how I found out.
    0:57:08 – Man you, like the football club?
    0:57:10 – No, like it’s you, man.
    0:57:12 – Oh, I see, okay.
    0:57:13 – Yeah, and then I called him and then I called Eli
    0:57:15 because like so many shows are like it’s an ensemble piece
    0:57:18 but like our show really is.
    0:57:20 If someone is not at their best every night,
    0:57:23 the show can so easily fall apart.
    0:57:25 Everyone is so dedicated.
    0:57:27 It’s funny that like I auditioned for those two roles
    0:57:31 and I know for a fact why I didn’t get those roles
    0:57:34 because those guys are perfect
    0:57:36 and I’m perfect for mine.
    0:57:39 – Would I like to win a Tony for sure?
    0:57:42 And I keep joking that I’m gonna like
    0:57:43 break their legs or whatever.
    0:57:45 But ultimately like, God, this is my Broadway debut
    0:57:48 in this play with this part and I got a Tony nomination.
    0:57:51 All right, whatever.
    0:57:52 – You’re saying like whatever,
    0:57:53 like you don’t even need to win it, you’re saying?
    0:57:55 – No, no, no, I want to win it.
    0:57:57 I’m telling you, I wanna win it.
    0:57:58 But if I don’t win it, it’s like, again, it’s cake.
    0:58:02 – Okay, so Tom, you are 36 years old.
    0:58:05 You’ve been at this for a while.
    0:58:06 This is your first time on Broadway
    0:58:08 and you find yourself in the kind of hit
    0:58:11 that happens quite rarely.
    0:58:13 Are you worried about, you know, what comes after?
    0:58:18 – I’m not worried, I’m more excited.
    0:58:20 And I don’t even think I know how much
    0:58:22 it’s opened the door to certain things.
    0:58:25 The morning of the Tony nominations,
    0:58:28 I was sitting with my girlfriend and I was like,
    0:58:31 okay, like a certain era of struggle for me is over.
    0:58:36 And that feels liberating.
    0:58:38 It was like a good 10 years of eating crap.
    0:58:42 I’m not worried about the next job
    0:58:44 in the same way that I was.
    0:58:46 – How struggling was the struggle?
    0:58:48 – It feels worse than it was.
    0:58:50 I’d been working pretty consistently.
    0:58:53 I’m very ambitious and like I wanna do the big stuff.
    0:58:57 My therapist said after I called her on Tony morning,
    0:59:00 she was like, did you think this would happen?
    0:59:02 I said, no.
    0:59:03 And then she was like, yeah, you did.
    0:59:04 Like, you were confused for so many years
    0:59:07 as to like, you knew that you were great
    0:59:09 and you knew that inside of you,
    0:59:10 you had something to offer,
    0:59:12 but like people weren’t recognizing it.
    0:59:14 And so that frustration, I think,
    0:59:17 was more of the struggle than like getting a job.
    0:59:20 – Sarah Pigeon is also nominated for a Tony Award
    0:59:26 in the same category as her castmate, Juliana Canfield.
    0:59:30 I asked Pigeon what it’s like to compete
    0:59:33 against her onstage bandmate and real life friend.
    0:59:37 – I’m just really excited to see everybody dressed up.
    0:59:39 It’s like theater prom.
    0:59:41 I sort of feel like we’ve all just won already.
    0:59:45 I remember taking the stage combat class
    0:59:47 and like, it doesn’t matter how good you are
    0:59:49 at doing a fake punch.
    0:59:50 If your partner doesn’t sell it,
    0:59:52 it’s like we’ve created this sort of spire web
    0:59:55 to hold each other up and support this piece
    0:59:58 that we all believe in so much.
    1:00:00 And theater people are amazing
    1:00:02 because they spend like hours every single day
    1:00:06 in dark theaters playing make-believe.
    1:00:10 Figuring out how to make most sense and be so magical
    1:00:13 and be thrilling and exciting and true.
    1:00:16 – Are you a little surprised
    1:00:17 at this relatively late stage in our civilization
    1:00:20 with so many modes of performing and entertaining,
    1:00:22 most of which are, you know,
    1:00:24 electronic or digital in some way now.
    1:00:26 Are you surprised that this old fashioned,
    1:00:29 hand-made theatrical thing still exists
    1:00:33 as intensely as it does?
    1:00:36 – I think that, you know, people like something real.
    1:00:40 It’s like a home-cooked meal.
    1:00:41 Sure, you can go and get, you know,
    1:00:43 penne pasta with vodka sauce in the freezer section,
    1:00:46 the Ralph’s, but like,
    1:00:48 if somebody makes you homemade penne pasta,
    1:00:51 it’s gonna taste better and you’re gonna wanna eat it.
    1:00:53 And then also with theater,
    1:00:54 and in particular with this show,
    1:00:57 it all happens in front of you
    1:00:58 if this were to be a movie one day.
    1:01:00 I would be curious to see how do they make,
    1:01:02 I think what’s so thrilling about this
    1:01:03 is that you see it all happen in real time
    1:01:06 and the music’s all live and you see the mess-ups
    1:01:09 watching someone do like a high-wire act of theater.
    1:01:12 They walk on stage and there’s nothing but the set
    1:01:16 and their body and their scene partner.
    1:01:18 And you can’t call cut and you can’t do it over
    1:01:21 is what’s so thrilling.
    1:01:22 It’s like one of the oldest art forms in the world,
    1:01:24 just storytelling.
    1:01:25 And I think there’s a reason that it’s lasted so long.
    1:01:28 I don’t think people go to see a robot theater performance
    1:01:31 maybe once, but I feel like it’ll close
    1:01:35 like six weeks after opening.
    1:01:36 – And I went back to David Ajmi, the playwright.
    1:01:43 Without him, none of this other stuff exists.
    1:01:48 I asked Ajmi if he wins the Tony for best play,
    1:01:52 what kind of speech she would give.
    1:01:54 – Or they just told me about this the other day.
    1:01:56 My publicist said I had to do it.
    1:01:58 – You hadn’t thought about it
    1:01:58 until your publicist told you?
    1:02:00 – No, because I’ve never done anything like this before.
    1:02:03 I don’t usually get these kind of prizes
    1:02:04 where you sit in the audience
    1:02:05 and then they call your name or they don’t call it.
    1:02:07 – Let’s assume that you’re drafting
    1:02:09 the beginning of an idea right now
    1:02:11 for your Tony acceptance speech, should you win.
    1:02:13 And maybe that’s terrible luck to even think about it,
    1:02:15 but if you’re willing to engage, what do you wanna say?
    1:02:18 – Well, Sue said, our producer said something like,
    1:02:21 I mean, we were talking about this the other day
    1:02:22 and I was like, Sue, let’s not have this conversation.
    1:02:24 But she said, you should not thank a lot of people.
    1:02:27 You should more say some personal thing.
    1:02:30 I can extemporize without going too crazy.
    1:02:33 So maybe I would extemporize on stage
    1:02:34 and just say what was inside of me.
    1:02:36 That’s what I like seeing.
    1:02:37 I wanna see someone talk about something
    1:02:40 that’s real to them in the moment.
    1:02:42 I mean, in the theater, everyone struggles so hard
    1:02:45 to get to where they are.
    1:02:46 It’s such a hard job.
    1:02:47 It’s a really weird job.
    1:02:49 – And there’s just something so moving
    1:02:50 about theater artists getting together
    1:02:52 and celebrating each other,
    1:02:53 not in the spirit of competition,
    1:02:55 but just like, look at us.
    1:02:56 Like we’re all doing this
    1:02:57 and somehow we’re surviving.
    1:02:58 How are we doing it?
    1:03:00 So that’s sort of maybe the spirit of which,
    1:03:02 if I’m lucky enough to be up there,
    1:03:03 I would say something like that.
    1:03:04 – That was pretty good to see.
    1:03:07 I told you I could do it.
    1:03:08 ♪ I’m gonna see you when I get there ♪
    1:03:11 ♪ I’ll see you when I get there ♪
    1:03:14 – The Tony Awards are on Sunday, June 16th.
    1:03:17 How many will Stereophonic win?
    1:03:19 We’ll let you know next week on part two.
    1:03:23 Also, what will the success of Stereophonic mean
    1:03:26 for the future of an industry that’s been dying forever?
    1:03:30 – I think the reason why,
    1:03:31 especially a lot of young people
    1:03:32 are coming to the theater in 2024 is that we forget
    1:03:37 because I think we have collective PTSD,
    1:03:39 but we were locked in our houses for three and a half years.
    1:03:42 And I think people want to be around each other.
    1:03:46 That’s next time on the show.
    1:03:47 Until then, take care of yourself.
    1:03:49 And if you can, someone else too.
    1:03:52 (upbeat music)
    1:03:54 Freakonomics Radio is produced by Stitcher and Renbud Radio.
    1:03:58 You can find our entire archive on any podcast app
    1:04:01 also at freakonomics.com,
    1:04:04 where we publish transcripts and show notes.
    1:04:06 This episode was produced by Alina Coleman.
    1:04:09 Our staff also includes Augusta Chapman,
    1:04:11 Dalvin Abouaji, Eleanor Osborne,
    1:04:14 Elsa Hernandez, Gabriel Roth, Greg Rippen,
    1:04:16 Jasmine Klinger, Jeremy Johnston, Julie Kanfer,
    1:04:19 Lyric Bowditch, Morgan Levy,
    1:04:21 Neil Coruth, Rebecca Lee Douglas,
    1:04:23 Sarah Lilly, Teo Jacobs, and Zach Lipinski.
    1:04:26 Our theme song is “Mr. Fortune” by The Hitchhikers.
    1:04:29 Our composer is Luis Guerra.
    1:04:32 Additional music in this episode by Will Butler,
    1:04:34 Justin Craig, and the cast of Stereophonic.
    1:04:38 As always, thanks for listening.
    1:04:43 – Oh, thanks, you gave me some tissues.
    1:04:45 (blows raspberry)
    1:04:46 – Mm, glad we got that on tape, though.
    1:04:47 (laughs)
    1:04:49 – I hope you can cut that out.
    1:04:51 (upbeat music)
    1:04:53 – The Freakonomics Radio Network,
    1:04:57 the hidden side of everything.
    1:04:59 (upbeat music)
    1:05:02 Stitcher.
    1:05:03 (upbeat music)
    1:05:06 you

    Hit by Covid, runaway costs, and a zillion streams of competition, serious theater is in serious trouble. A new hit play called Stereophonic — the most Tony-nominated play in history — has something to say about that. We speak with the people who make it happen every night. (Part one of a two-part series.)

     

     

  • 591. Signs of Progress, One Year at a Time

    AI transcript
    0:00:00 Hey there, it’s Stephen Dubner.
    0:00:06 The other day I sat back and I took a look at the work we’ve been putting out on Freakonomics
    0:00:11 Radio over the past few months.
    0:00:13 I’m really proud of it.
    0:00:14 I think a lot of the episodes are very strong, but a lot of the topics are tough.
    0:00:19 The continuing opioid epidemic, the political and economic issues around immigration, both
    0:00:26 legal and illegal, the boom in fraud among academic researchers, and how the private
    0:00:32 equity industry is making our economy ever more top heavy.
    0:00:37 Like I said, good episodes, but yeah, serious stuff.
    0:00:41 Also, there are wars going on all over the place.
    0:00:45 Our former and maybe future president just became the first presidential felon.
    0:00:50 I could go on and on, and I’m sure you could too.
    0:00:53 So today we are bringing you something a bit different, a bit lighter to head into summer.
    0:00:59 Something to think about, maybe talk about on your cross country road trip, or while
    0:01:04 you’re working in the garden, or maybe flying to another continent to visit family or go
    0:01:09 to a wedding or just catch your breath.
    0:01:12 As you know, we spend a lot of time on the show simply looking for interesting new things
    0:01:17 in the world and trying to explain them.
    0:01:20 These guests is very good at finding such things.
    0:01:23 For instance.
    0:01:24 There is this thing called Takubin.
    0:01:28 If you’re travelling around Japan, rather than hauling your bags from hotel to hotel,
    0:01:33 there’s a whole system, every hotel apparently has it, you send it on and they ship your
    0:01:37 bags around for you.
    0:01:39 I’d never heard of that before.
    0:01:41 And then you sort of think, well, why don’t we have that?
    0:01:43 Yeah, why don’t we?
    0:01:44 That I don’t know.
    0:01:46 I only know the facts, nothing else.
    0:01:49 Today on Freakonomics Radio, facts that will make you think twice, that may make you grimace
    0:01:55 or laugh, that will hopefully help you catch your breath and look at this wondrous, weird
    0:02:01 world of ours in a slightly new way.
    0:02:16 This is Freakonomics Radio.
    0:02:18 It’s a podcast that explores the hidden side of everything with your host, Stephen Dubner.
    0:02:27 All right.
    0:02:33 First things first, a proper introduction is in order.
    0:02:36 I’m Tom Whitwell.
    0:02:38 I am a consultant and you’ve stuck with my difficult question, first of all.
    0:02:46 Okay.
    0:02:47 Let me help out a bit.
    0:02:48 Whitwell works at a London consulting firm called Magnetic.
    0:02:51 They specialize in innovation and design.
    0:02:54 Not your usual consultants is how they put it.
    0:02:57 Among the clients that Whitwell has worked with are National Grid, the big UK power company,
    0:03:03 Vogue Business, a spin-off from The Fashion Magazine, and the candy and chocolate company
    0:03:08 Mars, which, as we will learn in today’s episode, also makes something that is very
    0:03:13 much not candy or chocolate.
    0:03:16 Before he got into consulting, Whitwell was a journalist with magazines and with The Times
    0:03:21 of London.
    0:03:22 He also designs electronic musical instruments, some of which have been bought by Tom York,
    0:03:27 the Radiohead.
    0:03:29 But none of that is why we’re speaking with Tom Whitwell today.
    0:03:34 We’re speaking with Tom Whitwell today because of another thing he does.
    0:03:39 Every year I write a list called 52 Things I Learned.
    0:03:42 Whitwell has been publishing his list of 52 Things He’s Learned every year for the past
    0:03:47 10.
    0:03:48 He publishes it himself on the blogging platform Medium, but then it ricochets all around
    0:03:54 the interweb, or at least certain precincts of it, where it is greeted with enthusiasm
    0:03:59 and wonder.
    0:04:01 It is a weird list in the best way.
    0:04:04 Nearly all the items are, at the very least, informative and interesting.
    0:04:08 Some are sad, but some are joyful.
    0:04:11 The joy is generated by, as Richard Feynman might have said, the pleasure of finding
    0:04:16 things out, and for Whitwell himself, the pleasure of sharing these things.
    0:04:22 The items are short, pithy, word perfect.
    0:04:26 Here’s one from last year’s list.
    0:04:28 Only 28 books sold more than 500,000 copies in the US in 2022.
    0:04:33 Eight of them were by romance novelist Colleen Hoover.
    0:04:37 Here’s one from the 2015 list.
    0:04:40 In China, cigarette companies are allowed to sponsor schools with slogans like genius
    0:04:45 comes from hard work, tobacco helps you become talented.
    0:04:50 And this one from 2021.
    0:04:52 10% of US electricity is generated from old Russian nuclear warheads.
    0:04:59 As a consultant, Whitwell engages with a wide variety of topics.
    0:05:04 I asked if most of his 52 things are a byproduct of his day job.
    0:05:09 They’re certainly bits where part of the job means I will be immersed in one particular
    0:05:14 subject for a few months, and then another subject for a few months afterwards.
    0:05:18 I think if I went back and looked over the years, I would say, “Oh, that’s why I was
    0:05:23 doing an electricity project,” or “That’s why I was doing a fashion project.”
    0:05:27 How much do you enjoy your day job?
    0:05:30 I enjoyed a lot.
    0:05:31 The variety is the key thing.
    0:05:33 Typically, a project might last three weeks to about six months.
    0:05:38 So every few months, you’re fundamentally changing in a completely different environment.
    0:05:43 A couple of months ago, we were asked to help Mars, who produce chocolate and pet food,
    0:05:49 they have a chain of stores around.
    0:05:52 I’m sorry, I don’t mean to laugh, but somehow chocolate and pet food in the same sentence.
    0:05:56 Exactly.
    0:05:57 Conjure’s images, I’d rather not conjure, but please continue.
    0:06:01 And we do a lot of work for them.
    0:06:02 They might come and say …
    0:06:04 Would some of your work be for them to not describe themselves as a chocolate and pet
    0:06:09 food company?
    0:06:10 No, I think that will be marketing, and we don’t really do that.
    0:06:14 So one piece of work I did for them, they have a research station in the UK, which has
    0:06:21 a large number of cats and dogs living in comfortable and pseudo-domestic situations.
    0:06:27 And they came to us and said, “We want to be sure
    0:06:30 we’re using the best technology to track them, to monitor them, to understand what they’re
    0:06:35 doing, and we want somebody to just spend a little bit of time looking around the market
    0:06:41 and suggesting different ways you might do this.”
    0:06:44 And so I spent two weeks or something researching that area.
    0:06:49 How do people track animals?
    0:06:50 How do they understand what they’re doing?
    0:06:52 How do they monitor them?
    0:06:54 So a project like that gives you an opportunity to find pet-related facts that might appear
    0:06:59 on the list of 52 things you learned that year?
    0:07:02 Yeah.
    0:07:03 One year has a piece about weightlifting dogs, and that came from some research we were doing
    0:07:09 for Mars, who I hastened about us certainly not considering weightlifting dogs as a thing
    0:07:14 to try and sell.
    0:07:15 Oh, you mean a person lifting a dog?
    0:07:17 I was imagining a dog on a bench press.
    0:07:20 No, dogs lifting weights.
    0:07:22 Dogs wearing, for example, weighted little waistcoats, dogs having protein shakes, dog
    0:07:30 influencers who are big, muscly dogs, who advertise dog protein shakes.
    0:07:35 And I think there’s some kind of yard equipment that are good for dogs to lift things up,
    0:07:39 so essentially dogs bench pressing things.
    0:07:42 I see.
    0:07:43 And is that something that the dogs choose to do?
    0:07:46 I didn’t get too deeply into that.
    0:07:47 I discovered this thing existed.
    0:07:50 I was asked in that to say, let’s look at the outside edge.
    0:07:53 What are the strangest things that pet parents are doing?
    0:07:57 Something like that will leak over into 52 things because if I’m spending a few weeks
    0:08:01 researching something like that, I will normally find quite a lot of interesting things and
    0:08:06 store them away to put in the list.
    0:08:09 Witwell has a history of curating odd and interesting things.
    0:08:14 Back in the 2000s, I wrote a blog when people had blogs called Music Thing that was all
    0:08:19 about here are interesting, funny, weird pieces of music equipment.
    0:08:25 Can you give a couple of examples?
    0:08:26 It’s kind of endless.
    0:08:27 There is an enormous installation on the coastline which are pipes that are played by the waves
    0:08:35 coming in and going out.
    0:08:36 There’s a big music conference called NAMM, which is the big trade show.
    0:08:41 And every year you will find extraordinary things that people invent to do music, whether
    0:08:47 it’s quadruple necked guitars or folding drum kits or whatever it is, it’s one of those
    0:08:53 areas where loan entrepreneurs and inventors can come up with things and they can find
    0:08:59 a big audience and they can get things out there.
    0:09:01 Okay, so take us through the origins of your 52 things I learned list.
    0:09:06 In 2014, I had left The Times, I had fallen out with the editor and it became clear I
    0:09:12 needed to find a different job.
    0:09:14 While I was unemployed and looking around for things to do, I had this idea of collecting
    0:09:21 things that I’d found during the year.
    0:09:23 I was always a fan of the list of colours, the genre, and my ambition for it was that
    0:09:29 I was obviously looking for a job, so I was looking for ways to reach out for people in
    0:09:35 London who I could reach out to and I thought, well, if I can get a thousand people to look
    0:09:40 at this, then that would feel like out of that a few of those people are going to be
    0:09:45 people who might be able to offer me a job.
    0:09:49 So it was kind of a creativity resume or ingenuity resume, maybe you’re showing people what your
    0:09:56 brain’s interested in, hoping they’d be interested in your brain too?
    0:09:59 Yeah, it was exactly that or it was content marketing for me, I suppose.
    0:10:04 Can you describe the, you know, either the characteristics of something you discovered
    0:10:07 that you know will be a good link or maybe the emotion you feel or the cognitive jolt
    0:10:15 you get when you come upon something that you know will be good?
    0:10:19 The simplest thing is it’s probably something that is counterintuitive.
    0:10:22 It’s not what you expect.
    0:10:24 It’s something that maybe seems to have some slightly bigger resonance, but it doesn’t
    0:10:29 have to.
    0:10:30 How much do you care about a sort of news peg if you sent yourself something in February
    0:10:34 that was on a topic like transportation safety and then that year there happened to be a
    0:10:39 bunch of bridges collapse?
    0:10:41 I assume you tend to gravitate toward the Peggy things?
    0:10:46 Not really, no.
    0:10:47 I probably do ignore that completely, the news peg.
    0:10:50 There was something that always slightly frustrated me working in newsrooms and there will often
    0:10:54 be stories that are, you know, two years old, five years old, ten years old.
    0:10:58 They don’t need to all have been published that year at all.
    0:11:01 I don’t really pay any attention to that.
    0:11:04 Let’s go to 2022, 52 things you learned in 2022.
    0:11:09 This is item number 30.
    0:11:11 By the way, is there any relevance to the order?
    0:11:14 Just shuffling really.
    0:11:15 Try to make sure the first 10 are really good and then they’re reasonably random so you
    0:11:20 don’t get three similar ones.
    0:11:21 So number 30 from the year 2022 was in the 1920s, new car sales were falling.
    0:11:30 So the industry promoted the term jaywalking to blame accidents on pedestrians rather than
    0:11:36 aggressive drivers.
    0:11:38 That is such an appealing catnip-y item on so many levels.
    0:11:42 So talk me through it and what I really want to know is how confident we are that that
    0:11:47 is in its totality true.
    0:11:50 With something like that, the question is, is this clickbait or is this a real thing?
    0:11:55 And I would be very confident that was true because, well, I was going to say I’ve read,
    0:12:00 I haven’t read.
    0:12:01 I’ve flipped through the book, Fighting Traffic by Peter D. Norton, which is all about the
    0:12:08 early years of the car industry.
    0:12:11 And the critical point seems to have been in around 1922, 23, 24 when it wasn’t a decline
    0:12:20 in sales.
    0:12:21 It was a decline in growth.
    0:12:22 And at the same time, there was this feeling that cars were pretty dangerous.
    0:12:28 People were getting killed by them.
    0:12:30 There was a petition in Cincinnati to limit the speed of cars to 25 miles an hour, which
    0:12:35 I thought was interesting because at the moment the speed limit across most of London is 20
    0:12:40 miles an hour.
    0:12:41 So car companies saw that this was a problem.
    0:12:45 And this notion of jaywalking, which should evolve, I think, organically as a word, really,
    0:12:50 the idea that people were country bumpkins and they were walking around and they didn’t
    0:12:56 know that there was big cars zooming past.
    0:13:00 And a jay was a word used by whom to mean what?
    0:13:03 I think it meant country folk, kind of rustics.
    0:13:06 American?
    0:13:07 It was an American.
    0:13:08 An American, yeah.
    0:13:09 This is all American, I think.
    0:13:10 Before then, roads were for people.
    0:13:12 If you look at pictures of roads before cars, you had big, wide roads and they were full
    0:13:18 of people and horse drawn vehicles.
    0:13:21 Bicycles.
    0:13:22 I suppose they look in some ways like when you see pictures of Chinese roads in the 80s
    0:13:27 when you see enormous torrents of bicycles going across, but you wouldn’t see cars.
    0:13:30 And this idea that the curb was a barrier that must not be stepped across.
    0:13:36 I think the really nice explanation of this was when the idea of jaywalking came along,
    0:13:41 the pedestrian felt they were wrong.
    0:13:43 They felt they were wrong to be in the road.
    0:13:45 The road no longer belonged to them, it belonged to cars.
    0:13:48 Exactly.
    0:13:49 Car firms would hire boy scouts to give cars the pedestrians saying, we’re a new era.
    0:13:55 This is old fashioned, what you’re doing.
    0:13:57 Don’t be a jay.
    0:13:58 Don’t be a jay.
    0:13:59 Don’t cross the road like that.
    0:14:00 And how strong is the evidence that it was actually the auto industry that built and
    0:14:05 encouraged this movement to the point where laws were written, forbidding it?
    0:14:10 I am only basing my evidence on Mr. Norton’s book.
    0:14:14 But he tells a very clear story that the relationship between the American Automobile Association
    0:14:20 and the National Safety Council got closer.
    0:14:24 And there was a guy called Charles Price who had worked for the National Safety Council.
    0:14:30 And he was the person who came to the industry and said, you need to own safety.
    0:14:36 For example, go into schools and say, we’re going to teach people road safety.
    0:14:41 Road safety meant get out of the road, it’s not for you.
    0:14:44 So how did jaywalking laws come about?
    0:14:47 And was any segment of the auto industry directly affiliated with that?
    0:14:52 I don’t know exactly that.
    0:14:54 I think they came in.
    0:14:56 It’s funny coming from the UK.
    0:14:58 This whole concept of jaywalking is alien to us.
    0:15:01 We have no law like that.
    0:15:03 But pedestrians do seem to be quite obedient in the UK because there are crossing lights
    0:15:09 and all things like that.
    0:15:10 Yeah, we just don’t have laws about it.
    0:15:12 No policeman will ever go and tell somebody off or give them a ticket for crossing the
    0:15:18 road.
    0:15:19 To be fair, I think that almost never happens in America.
    0:15:21 The only time that’s ever happened to me in my life, and I jaywalk always everywhere,
    0:15:25 was in Vancouver.
    0:15:27 And I wasn’t even crossing mid block.
    0:15:29 I was crossing at the intersection against the light.
    0:15:32 There was no traffic.
    0:15:33 And someone, you know, stopped me.
    0:15:36 And I laughed.
    0:15:37 And from reading about it, it does seem like people like you or me are generally not stopped
    0:15:42 for jaywalking.
    0:15:43 I have read that there was a department of justice report on the Ferguson, Missouri police
    0:15:48 department, the place where Michael Brown was killed by a police officer, which became
    0:15:52 a flash point in racial policing, said that 95% of the people there cited for jaywalking
    0:15:59 are black.
    0:16:00 Now, I don’t know what share of the population there is black, but still that sounds like
    0:16:03 an aggressively high number.
    0:16:04 I’m curious what kind of feedback you received or additional information maybe about jaywalking
    0:16:11 when you published that piece.
    0:16:12 I don’t remember.
    0:16:13 I mean, you’ve got to remember that piece was, what, 14 words.
    0:16:16 So I don’t think I saw anything particularly with that.
    0:16:18 I mean, there’s a sort of thread of those kinds of stories.
    0:16:21 The kind of story where an industry or a company or maybe a government is behind something that
    0:16:28 you may think emerged naturally.
    0:16:31 Is that what you mean by that kind of story?
    0:16:33 Exactly that.
    0:16:34 One of my favorite ones, which was a fact-checking challenge, but I do think was probably true.
    0:16:39 The way I wrote it up was that Fondue was invented by the cheese industry, which does
    0:16:44 seem to be more or less true in that Fondue did exist as a kind of niche Swiss dish.
    0:16:51 But the Swiss cheese industry extensively promoted the idea that this was something that
    0:16:57 families in America might be doing and that you could buy a Fondue set.
    0:17:02 Another item in this category then of inventions that come from perhaps interested sources
    0:17:10 rather than disinterested sources would be your item about the invention of the carbon
    0:17:14 footprint.
    0:17:15 Yeah.
    0:17:16 This was really interesting.
    0:17:17 So this was in, I think 2001, BP British Petroleum.
    0:17:23 It was called BP Amaco previously.
    0:17:25 It used to be British Petroleum.
    0:17:27 They even changed their name, didn’t they?
    0:17:28 They called it Beyond Petroleum.
    0:17:30 I’m not certain if that was actually their official company name or if that was their
    0:17:36 slogan, but there was a great piece by one of the ad executives who worked on it who
    0:17:42 said how oil company advertising always used to be aimed essentially at investors and
    0:17:48 the industry.
    0:17:49 And it generally consisted of helicopter shots of oil tankers with somebody with a kind
    0:17:56 of Morgan Freeman voice saying, we’re working hard to help the world work hard or something
    0:18:03 like that.
    0:18:05 That was the way all the companies were advertised.
    0:18:07 And then come 2000 and you’ve got the real beginnings of concern about, I mean, not the
    0:18:13 beginnings of concern about global warming, but more and more of that.
    0:18:16 And I think at this stage, the only oil company that acknowledged that global warming was
    0:18:21 a real thing was BP and their advertising switched completely instead of these kind
    0:18:28 of helicopter shots and we’re making the world go round.
    0:18:32 They went out onto the street and they interviewed people talking about climate change and talking
    0:18:40 specifically about their part in climate change and what they should do.
    0:18:45 And they created a calculator so you could go on and tap in stuff about your lifestyle
    0:18:51 and how many holidays you went on, this kind of thing.
    0:18:54 And you’re saying this carbon footprint calculator was created for BP by its ad agency, the very
    0:19:02 famous Ogilvian Mather.
    0:19:03 Is that right?
    0:19:04 Yeah.
    0:19:05 You got some kind of sum for how much weight of carbon you were responsible for.
    0:19:10 It just seems like such an interesting and telltale shift, the idea from we are the company
    0:19:16 that is making the world go round to as soon as that becomes problematic or questioned,
    0:19:23 it’s now we’re interested in you and your responsibility and what you as a consumer
    0:19:27 are doing.
    0:19:28 It does strike me as interesting, if not paradoxical, that you, a consultant who helps firms do
    0:19:37 a variety of things, but especially change behavior, either their own behavior or the
    0:19:41 behavior that their customers and so on, are highlighting in many of your items, the fact
    0:19:48 that advertisers, marketers and firms are trying to change behavior in order to suit
    0:19:55 their own needs without those needs being obvious.
    0:19:59 I suppose so.
    0:20:00 I’m not somebody who works in marketing, I may be slightly more skeptical about marketing
    0:20:06 than some people.
    0:20:07 When you say you may be slightly more skeptical, why is that?
    0:20:11 Something like the jaywalking story or the carbon footprint story, I think is amazing
    0:20:16 in how it genuinely changes the way we as individuals perceive the whole playing field.
    0:20:24 It’s not like you’re thinking product X is better than product Y, there’s that famous
    0:20:28 story about when they’re trying to get women to smoke cigarettes and the idea of torches
    0:20:34 of freedom, which is to encourage women to, that feels quite direct, but the entire notion
    0:20:40 of how we interact with the street being changed by a marketing campaign feels amazing to me.
    0:20:48 How many people each day are thinking slightly differently as they walk along the pavement
    0:20:52 because of that campaign 100 years ago?
    0:20:58 After the break, more echoes of the past and perhaps more harbingers of the future.
    0:21:04 I’m Stephen Dubner, this is Freakonomics Radio, and we will be back with Tom Whitwell
    0:21:09 right after this.
    0:21:22 Tom Whitwell is a collector of interesting facts.
    0:21:26 He spends his year reading widely, websites and blogs, newspapers and magazines, books
    0:21:31 and journals, and then he presents his harvest each December in a list of 52 items.
    0:21:38 Most items are short, just a sentence or two, often they have nothing to do with the previous
    0:21:44 year.
    0:21:45 For instance, this one about Ibn Battuta, the medieval explorer.
    0:21:49 When Ibn Battuta visited China in 1345, facial recognition was already in use.
    0:21:56 All visiting foreigners had their portraits discreetly painted and posted on the walls
    0:22:01 of the bazaar.
    0:22:02 Here’s another.
    0:22:04 When users download the Kenyan Mobile Loans app Ocache, the software’s terms and conditions
    0:22:09 quietly give it permission to access their contacts.
    0:22:13 If they fall behind in repayments, the app starts to message all those contacts to shame
    0:22:19 the user into repaying the debt.
    0:22:22 Whitwell’s skill at distilling a long thing into a short thing comes from his time as
    0:22:28 a magazine editor.
    0:22:29 It was almost a bit like, you know, pull quotes in magazines where you’ve got a magazine article
    0:22:33 and you find the little quote that is the important bit from the article.
    0:22:37 That important bit is then reprinted in a bigger font inside the body of the article.
    0:22:43 This acts as a sort of billboard or a secondary headline for the article.
    0:22:48 And that’s the thing that often gets read far more than anything else because people
    0:22:51 don’t read the body copy but they scan over and they read the pull quotes.
    0:22:55 Even what I was doing was reading an article online and then finding the pull quote and
    0:23:00 keeping that in a list, keeping a store of that.
    0:23:04 Given the state of AI in 2024, if I give chat GPT or perplexity a 2000 word article and
    0:23:12 I give Tom Whitwell the same article, do you think you’ll do better at finding what might
    0:23:15 be judged to be the best pull quote or worse?
    0:23:18 So I have tried this quite a lot.
    0:23:20 I’ve done experiments with this over the years.
    0:23:24 I think I would probably have a pretty good chance of finding a more interesting, more
    0:23:29 distinctive take.
    0:23:30 I’ve done things like obviously asking chat GPT to come up with things for the list and
    0:23:37 it can cut with fictional ones that are kind of fine.
    0:23:42 But obviously the fact they’re fictional does make them a lot less interesting than if they
    0:23:45 were real.
    0:23:46 I think AI at the moment does seem to struggle to find that quirkiness and distinctiveness.
    0:23:54 Let’s go to 2017, item number 18, the NHS National Health Service, that’s the British
    0:24:01 national health system, uses more than 10% of all pagers in the world.
    0:24:07 Tell me about that, how much we trust that claim, etc.
    0:24:10 So this is a really, really interesting one.
    0:24:12 So 2017, I saw an article in the Economist that had this stat in it.
    0:24:19 And because it was the Economist, I trusted it, I put it on the list.
    0:24:23 After 2017, it became a sort of political issue in the UK.
    0:24:29 The fact that we were using pagers somehow showed that the NHS was not in a good state.
    0:24:35 It was not being well managed.
    0:24:37 In 2019, the government put out a press release that said pagers are going to be banned by
    0:24:44 2021.
    0:24:45 They did say they’re going to be banned except for emergencies, which obviously in a hospital
    0:24:49 context is quite a large loophole, I think.
    0:24:53 And obviously between 2019 and 2021, quite a lot happened in the healthcare sphere.
    0:25:00 So I don’t think a tremendous amount has really happened with this.
    0:25:02 I think there are still a lot of pagers in use in the NHS.
    0:25:07 Now, the pro pager people argue that it does fill a gap, right?
    0:25:11 That it can be more reliable under certain circumstances, less prone to dead spots and
    0:25:15 so on.
    0:25:16 What do you know about that?
    0:25:17 I think like anything, it’s a combination of there’s issues around the technology and
    0:25:22 then there’s issues around culture and etiquette and how it works.
    0:25:26 I think these are also quite poorly understood.
    0:25:28 So I was talking to my dad.
    0:25:29 My dad used to be a hospital doctor.
    0:25:31 He started working in hospitals in 1968 and he said they had pagers then, these battery
    0:25:39 powered handheld devices that would go off and then you had to run and ring a number
    0:25:46 and they worked on a private radio network within the hospital.
    0:25:49 In the UK, they called bleeps, which I always think is quite sweet.
    0:25:53 I just found this really interesting.
    0:25:54 I actually spoke to a doctor called Constantino Regas, who’s an NHS doctor in Southampton
    0:26:01 and he previously sent freedom of information requests to every NHS trust in the country
    0:26:08 to say, how many pagers are you using?
    0:26:10 How much are you spending on it?
    0:26:11 What are you doing with it?
    0:26:14 He’s definitely anti pager.
    0:26:16 Because why?
    0:26:17 He said it’s a weird legacy aberration.
    0:26:21 He would talk about you’re on an eight hour shift, you finally get a chance to go to the
    0:26:26 bathroom and then you get bleeps and you have to run and it turns out it’s a nurse who wanted
    0:26:31 you to prescribe some paracetamol to somebody who’s going to be discharged tomorrow.
    0:26:35 So that he found very frustrating.
    0:26:37 He said different wards were different.
    0:26:40 Some were good.
    0:26:41 Some, he had the phrase, bleeped incessantly, which I imagine must be very irritating.
    0:26:47 But he also talked about having a crash bleep.
    0:26:49 So this is where you are a doctor around the hospital or a nurse around the hospital.
    0:26:53 You have this thing on you and it bleeps and you have to run to save somebody’s life, literally.
    0:27:01 I read an interview with a final year medical student who said, the first time I carried
    0:27:06 a crash bleep, I was more self aware.
    0:27:08 I felt older and more responsible than I’d ever felt in a clinical setting.
    0:27:12 So there’s a kind of status thing, but there’s also etiquette.
    0:27:16 You need a method to gather people.
    0:27:18 You need a method to communicate within the hospital.
    0:27:21 And some people will do that well and some people will do that badly.
    0:27:24 And that frustration has been mapped onto a particular device, which I think is unfair.
    0:27:31 I am in some ways pro-pager.
    0:27:34 The basic story was the NHS uses 10% of remaining pages.
    0:27:38 I would imagine the other 90% are in American hospitals.
    0:27:41 So whether or not that 10% is accurate, and I’ve seen it challenged on a couple of dimensions,
    0:27:46 but whether or not that’s accurate, the fact is that if you look around the world a little
    0:27:50 bit, you do see that older technologies often have long and productive afterlives.
    0:27:55 Can you talk about any other technologies that you see that are used maybe not so prominently,
    0:28:01 but seriously, that one might think had disappeared?
    0:28:05 Facts machines are still used in Japan quite a lot.
    0:28:08 My assumption is that is something to do with handwriting and having a very complicated
    0:28:13 script.
    0:28:14 That may be wrong.
    0:28:16 What about computer programming that is in languages that almost nobody learns anymore?
    0:28:21 That absolutely is an issue.
    0:28:22 COBOL is one of those languages.
    0:28:25 And you often see stories where a particular organization, it might be an old pension fund,
    0:28:31 has that requirement that they need to hire people to bring those things to life.
    0:28:35 The other big one is floppy disks.
    0:28:37 I think until very recently, there were systems on Boeing 747s that relied on floppy disks.
    0:28:43 These legacy systems do exist and often work well.
    0:28:46 They are often just fine.
    0:28:49 With the pages, the idea that you can spend an awful lot of money tearing out one system
    0:28:54 and putting in another system is an idea that people who sell systems often promote.
    0:29:01 In that press release, when the pages were banned, part of their evidence was they said
    0:29:06 there are 130,000 pages in the NHS and it’s costing 6.6 million pounds a year.
    0:29:12 You hear that and you go, well, that sounds bad until you realize that’s 50 pounds per
    0:29:16 page or per year.
    0:29:17 It’s less than a pound a week.
    0:29:19 For a critical healthcare piece of infrastructure, it’s probably the best bargain ever.
    0:29:25 Here’s an item from your 2023 list that I was particularly interested in.
    0:29:29 Item number five says job satisfaction in the US is at a 35-year high, not low, which
    0:29:36 is what I think everybody would be expecting.
    0:29:38 You’re right that in 2010, less than 45% of people said they were satisfied with their
    0:29:42 jobs but in 2022, over 62% said they were.
    0:29:46 You’re right further that you need to go back to the 80s to find satisfaction as high as
    0:29:51 today.
    0:29:52 Talk to me about that.
    0:29:53 First of all, were you as surprised as I was to read that number?
    0:29:56 I was really surprised by that.
    0:29:58 It was at a time when we had high inflation, a real sense of uncertainty in the economy
    0:30:05 and uncertainty in people’s careers.
    0:30:08 It did absolutely seem just really counterintuitive.
    0:30:11 How can this be right?
    0:30:13 There obviously are other surveys.
    0:30:15 This was the survey by the conference board.
    0:30:18 Which is funded by whom or represents whom?
    0:30:21 It’s an American organization.
    0:30:22 I don’t know an enormous amount about it, but it does seem to be a very large and well-trusted
    0:30:29 industry body.
    0:30:30 Most of the things people were satisfied were the people they work with commuting.
    0:30:36 More than 65% of people were satisfied with commuting, which I found interesting.
    0:30:40 Job security, physical environment.
    0:30:43 What I found really interesting was the change.
    0:30:47 Over the last maybe 10 years, one of the big changes has been in performance reviews, which
    0:30:53 I was just interested because it’s such a unglamorous part of working life.
    0:31:00 No politician has ever stood up and said, “I’ve got a grand vision for performance reviews
    0:31:04 and this is how I’m going to change the world.”
    0:31:06 But this survey suggests that there is a real fundamental shift in the last just 10 years
    0:31:12 that you’ve got millions of people who were made unhappy by that process, who now are
    0:31:21 happier and more satisfied.
    0:31:22 I think we’ve all met people and possibly had experience yourself of those old school
    0:31:27 performance reviews where once a year you’d go and sit with your boss and they would
    0:31:32 say something that annoyed you or made you think, “They really don’t understand who
    0:31:36 I am at all.
    0:31:37 They don’t understand what I do in this company.”
    0:31:39 And you were furious for the next six months and that idea that training in HR is actually
    0:31:47 fixing things like that, I found counterintuitive and really interesting.
    0:31:52 I do see that the conference board is a non-profit and non-partisan research group made up of
    0:31:59 over a thousand public and private corporations and other organizations encompassing 60 countries.
    0:32:05 Maybe it’s not so surprising that a firm representing big corporations says, “Hey, guess what?
    0:32:11 People at corporations are actually much happier than you think.”
    0:32:15 But let’s assume that there’s some truth in these numbers.
    0:32:19 I’m curious to know what it may say about the rise and or triumph of the HR department
    0:32:26 in firms.
    0:32:27 Do you think it’s kosher to make that kind of connection?
    0:32:31 That’s how I understood it.
    0:32:32 I do think that that is an area which, as I said, is very unglamorous and really celebrated,
    0:32:39 but it’s a place where there are people who are very committed to what they’re doing and
    0:32:43 they’re experimenting and they’re changing.
    0:32:45 Like instead of having one big annual review, we should have continuous assessment, these
    0:32:51 sorts of things, those ideas spread in five, 10 years and they seem to work a lot better.
    0:32:59 So this is about job satisfaction in the US.
    0:33:02 What can you tell us about in your country, the UK?
    0:33:04 I don’t know because I haven’t read a survey as extensive as this.
    0:33:08 I think the real challenge is that counterintuitive split between a kind of national narrative,
    0:33:16 which certainly in the UK is of quite a lot of doom and gloom at the moment for a whole
    0:33:21 range of reasons.
    0:33:22 Considerably more than the US at the moment, as much as ours may feel gloomy.
    0:33:26 Yeah, I think there’s a classic newsroom thing, which is something that is bad and critical,
    0:33:33 is reportable and is interesting and is seen as important.
    0:33:37 Something that is, this has improved by 5% since last year.
    0:33:41 It’s almost impossible to report, and that’s not because there’s a grand conspiracy stopping
    0:33:45 it.
    0:33:46 It’s just very hard to make that sort of story work, but after a few years of 5% improvements,
    0:33:51 you really start to get a change in the way people work and people feel and in happiness.
    0:33:59 Here’s to finding happiness wherever it can be found.
    0:34:03 After the break, if someone tells you they are 100 years old, should you believe them?
    0:34:09 I’m Stephen Dubner.
    0:34:10 This is Freakonomics Radio.
    0:34:12 We’ll be right back.
    0:34:22 Given that we are in the sixth month of the year in our 12-month Gregorian calendar, Tom
    0:34:28 Whitwell is roughly halfway through collecting items for his 52 Things I Learned list for
    0:34:34 this year.
    0:34:36 Can you give us any kind of preview of 2024, or do you not do that, or would it be impossible
    0:34:41 even if you wanted to do that?
    0:34:43 Well, let me just look in my 52 Things folder and see what I’ve posted in recently.
    0:34:49 One that I saw just last week was there is a wonderful graph of, well, it’s not a wonderful
    0:34:56 graph.
    0:34:57 It’s a fascinating graph of global deaths from disasters.
    0:35:01 What’s really striking with this is how much it varies.
    0:35:06 There’s a really interesting thread about how we are getting much better at coping with
    0:35:09 those kind of disasters.
    0:35:11 So there’s a period from 2016 to 2021 when it was extremely low.
    0:35:17 Okay.
    0:35:18 I’m looking at this graph now too, and I see that in 2023 there was a spike.
    0:35:24 Where we go from, it looks like an average of around 35,000 deaths per year from natural
    0:35:30 disaster, then 2023 was like a tripling of that.
    0:35:33 So the point here is that life in this category is extremely random, yes?
    0:35:38 It is, but the thing I find interesting is that idea that there are ways that we are
    0:35:42 getting better at some of these.
    0:35:43 So there’s a whole thing about typhoons in places like Bangladesh and India, where they
    0:35:48 spend a lot of money building big, concrete shelters that he used to schools during the
    0:35:53 normal periods, but then everyone piles in and the deaths in some of those things have
    0:35:57 gone from being tens, hundreds of thousands of people dying to much, much smaller.
    0:36:03 I really appreciate that you seem to be a person who generally looks for the best in
    0:36:10 people or the world, but in one case, in your list from 2023, item number 15, you are basically
    0:36:21 calling a bunch of sweet, cuddly old people a bunch of liars.
    0:36:26 You write the number of super centenarians in an area tends to fall dramatically about
    0:36:32 100 years after accurate birth records are introduced.
    0:36:36 Walk me through this one, please.
    0:36:38 I’m especially interested to learn how much lying or maybe misremembering or uncertainty
    0:36:42 there may be for people who think they’re over 100 years old when in fact they’re not.
    0:36:48 So this is an amazing story.
    0:36:50 One of the things I always look at with these lists is something where it’s a little tiny
    0:36:55 nudge, you know, it’s a few lines.
    0:36:58 But if you go and get into it, you will discover this extraordinary rabbit hole.
    0:37:03 And that’s what I’ve done with this business of super centenarians.
    0:37:08 A lot of this relates to in the mid 2000s, this idea came about around blue zones.
    0:37:16 If you were somebody who read Sunday supplements of newspapers or if you watched National Geographic,
    0:37:22 they spent a lot of time talking about blue zones, which were areas where people lived
    0:37:26 remarkably long, like 110 years old.
    0:37:31 They talk about eating beans, drinking red wine, not too much food, little amounts of
    0:37:37 meat, natural exercise, not going to the gym but, you know, gardening, having friends,
    0:37:43 having a sense of purpose.
    0:37:44 A couple of academics, Italian and French academics, I think, identified an area in
    0:37:50 Sardinia that they felt had unusual longevity.
    0:37:55 Oliastra, it’s called?
    0:37:57 Yes.
    0:37:58 One of the things I thought, seeing this very casually, I thought the blue zones referred
    0:38:03 to like blue skies and blue sea.
    0:38:06 It’s just the software they used to draw the graph for the blue circle around that area.
    0:38:12 Anyway, they wrote this paper.
    0:38:14 They had a few suggestions in the original paper about what might be causing this longevity,
    0:38:20 which was slightly odd.
    0:38:21 They were to do with inbreeding and genetics, and a lot of it was about male and female longevity
    0:38:27 being different.
    0:38:28 A lot of that got lost because the paper caught the attention of a guy called Dan Butner.
    0:38:34 He started his career running celebrity croquet tournaments.
    0:38:39 He then did these three enormous transcontinental bike rides where he rode across the Americas
    0:38:45 and the Soviet Union.
    0:38:46 I’ve got in with National Geographic, discovered this report, and in 2008, published his book
    0:38:54 called Secrets of the Blue Zones or something like that with these kind of instructions
    0:38:59 around eating beans and drinking red wine.
    0:39:02 This has been an incredibly successful notion.
    0:39:05 I was on Oprah just last year, he had a Netflix series about this, but if we all sat around
    0:39:11 eating tomatoes and garlic, sitting in the sun, drinking wine with our friends, we would
    0:39:15 live to be 110.
    0:39:17 And you, Tom Whitwell, are here to tell us this is kind of all bullshit?
    0:39:20 Well, it’s not me.
    0:39:22 It’s an academic at Oxford called Saul Newman.
    0:39:26 He’s a demographer.
    0:39:27 He’s been publishing a pre-print of a paper.
    0:39:30 He published it first, I think, in 2019, and he’s updating and updating it.
    0:39:34 So it gets kind of longer and longer.
    0:39:36 And I can’t say I’ve ever read any other papers about developmental biology, but if
    0:39:42 they’re all like this, I want to read more of them because this is an extraordinary document.
    0:39:46 He just tears the entire thing to pieces from beginning to end.
    0:39:52 So a centenarian, if somebody lives past 100, a super centenarian, if somebody lives past
    0:40:00 110, Saul’s point is really that this is all not true.
    0:40:07 He says, “In Europe, where birth records are generally pretty well recorded.”
    0:40:11 So in the U.S., they’ve always been very poorly recorded.
    0:40:14 I don’t think birth certificates were used nationally until 1946 in the U.S.
    0:40:19 But in Europe, they were pretty well recorded.
    0:40:21 And these were usually state records or church records or family records?
    0:40:25 I think in small areas, they were sort of community records, I guess.
    0:40:29 He says, “Remarkable longevity is predicted.”
    0:40:33 If you want to find areas of remarkable longevity, and this is like 110 and above, you look for
    0:40:40 areas with poverty, low per capita incomes, short life expectancy, high crime rates, worse
    0:40:48 health, higher deprivation, as he says, “Relative poverty and short lifespan constitute unexpected
    0:40:56 predictors of centenarian and super centenarian status.”
    0:41:00 So his hypothesis is that these figures are not true.
    0:41:07 And are they not true primarily because of actual fraud, lying people saying something
    0:41:14 that they know to not be true, or the lack of good records, or just general uncertainty?
    0:41:20 I think it’s a combination, but probably fraud is a big part of it.
    0:41:25 The way I imagine this is you’re living in a small rural town in remote Greece or Italy.
    0:41:33 Somebody comes to you with an idea.
    0:41:34 They say, “I’ve got a mate who works in the council, and if we pay him a bit of money,
    0:41:40 he can change your age so that you as a 50-year-old, and now 60, so you get your pension.”
    0:41:46 So it’s not just you turn, whatever, 91 and you start telling people, “Yeah, I just hit
    0:41:51 100 just for pride,” you’re saying this was financially driven fraud sometimes.
    0:41:55 This is the suggestion.
    0:41:56 I got much darker, much faster than I expected, Tom.
    0:42:00 I thought it was just lovely old people exaggerating a little bit, but you’re saying they’re shakedown
    0:42:04 artists.
    0:42:05 And there’s lots of other things.
    0:42:06 I think there’s probably stuff around insurance where you’d get much cheaper insurance if
    0:42:10 your age was different.
    0:42:11 And then there’s also these complicated family situations where you might not want the crazy
    0:42:17 cousin to inherit the farm.
    0:42:19 So it’s very useful if the mother becomes the grandmother or vice versa, or children
    0:42:26 where the parenting of the child is slightly complicated.
    0:42:29 So there are a lot of possible things, and this isn’t unknown.
    0:42:33 So 2012, after the financial crisis in Greece, 20,000 people who were getting pension payments
    0:42:40 or welfare had that stopped.
    0:42:43 They were obviously investigating government spending because they were dead mostly.
    0:42:48 A quick side note, Witwell got the number wrong here on the number of Greeks who lost
    0:42:54 their benefits.
    0:42:55 It wasn’t 20,000, it was 200,000.
    0:42:57 All right, moving on.
    0:43:00 You might say, “Well, that’s Greece, but what about Japan?”
    0:43:03 Which generally has much stronger records.
    0:43:12 In 2010, 230,000 Japanese centenarians were discovered to be missing imaginary clerical
    0:43:15 eras or dead.
    0:43:17 This was an 82% error rate.
    0:43:20 And what are the blue zones in Japan?
    0:43:22 Okinawa is the blue zone in Japan.
    0:43:24 World War II was not good for Okinawa.
    0:43:28 Supposedly about 90% of their paper records were destroyed.
    0:43:33 After the war, if you needed documents, you would go to the U.S.-led military government.
    0:43:40 They didn’t really speak a great deal of Japanese, and they used a different calendar from the
    0:43:45 one in Japan.
    0:43:46 So the opportunities for confusion were significant there.
    0:43:49 In those places where there are supposedly a lot of older people, much older people,
    0:43:54 are there particular days of the month or months of the year where suspicious birthdays
    0:43:58 tend to cluster, for instance?
    0:44:00 There is a lot of that.
    0:44:01 Things like people are born on the first of the month, which just suggests that it’s probably
    0:44:08 been chucked in rather than thought about in too much detail.
    0:44:12 But the paper is relentless.
    0:44:14 It just goes on and on and on.
    0:44:16 Things like in France, there are 19 people over the age of 110 in the overseas departments.
    0:44:23 So that’s Guadeloupe, Martinique, French Guiana.
    0:44:26 Paris’s population is seven times larger, and it has 17 of these people.
    0:44:31 Which suggests that fraud of this sort, if it’s fraud, is easier in certain precincts
    0:44:36 than in others, where the record-keeping is very different?
    0:44:38 Yeah, fraud or just chaos.
    0:44:41 But there is more.
    0:44:42 So there’s another big factor in this.
    0:44:44 His argument is that it’s very unlikely that really anyone is 110.
    0:44:51 It’s very, very, very unlikely that there are clusters of people who are 110 in very
    0:44:56 poor areas with low life expectancy.
    0:44:58 But he then goes back to look at the main argument of this Blue Zones movement, is that people
    0:45:04 live a long time because they live what seem like healthy lives.
    0:45:10 And he looks into these areas to find how well they align with those healthy lives.
    0:45:15 Okinawa is the one he chooses.
    0:45:17 So one of the claims is people in these areas, they don’t go to the gym, but they live in
    0:45:24 environments that are nudging them to move without thinking about it.
    0:45:28 They have gardens, that sort of thing.
    0:45:30 Unfortunately, Okinawa, out of 47 prefectures in Japan, has the highest rate of obesity.
    0:45:39 And it’s not the lowest for gardening, because not surprising you Tokyo and Osaka are lower,
    0:45:47 but it’s the lowest after them.
    0:45:48 So they’re not healthy and they’re not gardening.
    0:45:52 Now, it’s possible that there was a cohort, however, that was, you know, an older cohort
    0:45:58 that did garden or that is not obese, right?
    0:46:02 We shouldn’t.
    0:46:03 No, that is certainly possible.
    0:46:04 I mean, if you look at cohorts, another of his is they have a concept called Ikegai, which
    0:46:10 means kind of purpose in life and why I get up in the morning.
    0:46:15 Unfortunately, Okinawa has the fourth highest rate of suicide in over 65s in the country.
    0:46:20 It’s not a very happy place, generally, he goes through all of these things like their
    0:46:25 meat consumption.
    0:46:27 The idea is that people in these blue zones eat very small amounts of meat, maybe five
    0:46:31 kilos of meat a year.
    0:46:33 In Okinawa, the average is 40 kilos.
    0:46:36 Okinawan residents each consume an average of 14 cans of spam per year.
    0:46:43 Well, it could be that spam has some magical longevity properties that we don’t know about
    0:46:48 yet.
    0:46:49 That wasn’t what he was telling Oprah, I don’t think.
    0:46:52 It’s not like the blue zones thing is evil.
    0:46:55 The advice does seem quite sensible.
    0:46:57 I’m sure we should all eat more vegetables, we should have a better social life.
    0:47:01 I do worry about connection between the idea that very poor people living on very, very
    0:47:08 meager resources can magically live a long time.
    0:47:12 And the problem with that supposition is what?
    0:47:14 Well, it’s that actually the opposite is true.
    0:47:17 So rich people live longer.
    0:47:20 Rich countries, the average life expectancy is 80 plus, poor countries, it’s 60 plus.
    0:47:27 It’s not mysterious or subtle.
    0:47:29 So what has been the response of Dan Butner and the pro-blue zone crowd?
    0:47:34 I have not been able to find any yet.
    0:47:36 There has certainly been back and forth with the early versions of the paper.
    0:47:40 I think the stuff that the blue zone organization is doing.
    0:47:43 It’s not like it’s a terrible thing, but it does feel from reading this like the basis
    0:47:49 of the research is, it’s probably quite a lot more complicated than that.
    0:47:55 The blue zones organization did in fact issue a response to Saul Newman’s critique, attacking
    0:48:00 his analysis along a variety of dimensions.
    0:48:04 For instance, even though some blue zones are high poverty areas, people there do,
    0:48:09 they wrote, enjoy very good or excellent public health services.
    0:48:14 Saul Newman then responded to their response.
    0:48:18 Here’s a quote.
    0:48:19 It was basically what you’d expect if you told the Yeti hunting society that Yetis
    0:48:24 did not exist.
    0:48:27 Is there a link or three from the past that you are just exceedingly proud of or happy
    0:48:33 about?
    0:48:34 I don’t know about proud or happy about.
    0:48:36 When you ask that, there are some that seem to kind of take on a life.
    0:48:40 Well, it’s more that they sort of make sense.
    0:48:42 So I remember I think in probably the first one, there was a story that China has completed
    0:48:49 a major dam project for every day since 1949, which to me just seemed like such an extraordinary
    0:48:59 way of understanding the world and kind of ambition and scale.
    0:49:04 Are there topics or types of ideas that you avoid?
    0:49:08 There’s definitely a kind of positive thing.
    0:49:11 I remember quite clearly in 2016, doing the list and thinking, actually, this feels quite
    0:49:16 important to do a list that is full of progress and things that are good in the world.
    0:49:24 Because why?
    0:49:25 2016, why?
    0:49:26 Because we had Brexit and Trump, essentially.
    0:49:28 And so there was such a strong narrative amongst people who are often on the Internet of just
    0:49:34 doom and gloom and everything is terrible in the world and you were constantly seeing
    0:49:37 stories and suggestions and evidence of things being terrible and trying to find those stories
    0:49:42 that were about progress or growth or improvement, those I felt were important.
    0:49:51 Can you just describe the process a little bit?
    0:49:53 I’m curious how formal it is, I’m curious how it unspools during the year and whether
    0:49:59 you’re diligently reading and saving up links and maybe even coming up with way more than
    0:50:05 52 that you have to weed down or is it the opposite?
    0:50:08 You find that in November, December, there’s this rush to get enough.
    0:50:13 How does it work?
    0:50:14 So I do it during the year.
    0:50:15 The way I do it now is when I find a link, I email it to myself with the words 52 things
    0:50:22 in the title.
    0:50:23 My Gmail has a filter and it drops them all into a folder and then come November, there’s
    0:50:30 usually a hundred or so in there and I just start going through it.
    0:50:37 And in the cold, light of day, some that excited you no longer excite you, I assume?
    0:50:41 Yeah, absolutely.
    0:50:42 And some I will have sent myself an article that kind of seems interesting but doesn’t,
    0:50:46 you know, I hadn’t actually worked out what the fact is.
    0:50:51 I am glad that Tom Witwell has taken it upon himself to work out what all the facts are.
    0:50:57 And I’m always delighted to read his annual list of 52 things.
    0:51:01 Maybe we’ll check in with him again at the end of this year to see what he’s come up
    0:51:04 with.
    0:51:05 Thanks to Tom for the good conversation today and thanks to you as always for listening.
    0:51:11 If you have learned some good things so far this year, send them along.
    0:51:15 I’d like to hear them.
    0:51:17 Your email is radio@freakonomics.com.
    0:51:21 Coming up next time on the show, if you are someone who used to go to the theater but
    0:51:25 has kind of given up on it, you’re not alone.
    0:51:29 But there is a new play on Broadway, a play that like Tom Witwell’s list is weird in
    0:51:36 all the right ways.
    0:51:37 It’s called Stereophonic.
    0:51:39 It’s the one all the rock stars are going to see.
    0:51:41 The Tony Awards are coming up and Stereophonic may bring home a bunch of them.
    0:51:47 You will find out why the show works the way it does and what that might mean for the future
    0:51:52 of Broadway.
    0:51:54 That’s next time.
    0:51:55 Until then, take care of yourself and if you can, someone else too.
    0:52:01 Freakonomics Radio is produced by Stitcher and Renbud Radio.
    0:52:03 You can find our entire archive on any podcast app or at Freakonomics.com where we also
    0:52:09 publish transcripts and show notes.
    0:52:11 This episode was produced by Alina Cullman with help from Daniel Moritz-Rabson.
    0:52:16 Our staff also includes Augusta Chapman, Dalvin Abouaji, Eleanor Osborne, Elsa Hernandez,
    0:52:21 Gabriel Roth, Greg Rippen, Jasmine Klinger, Jeremy Johnston, Julie Canfer, Lyric Bowditch,
    0:52:27 Morgan Levy, Neil Carruth, Rebecca Lee Douglas, Sarah Lilly, Teo Jacobs, and Zac Lipinski.
    0:52:32 Our theme song is Mr. Fortune by The Hitchhikers.
    0:52:36 Our composer is Luis Guerra.
    0:52:43 I remember very clearly, after a few years when it did seem to have a kind of audience,
    0:52:48 imagining people like Benedict Evans or the marginal revolution people, looking at it
    0:52:54 and going wrong, wrong, boring, wrong, boring, 34 clickbait.
    0:53:02 That was my nightmare.
    0:53:06 The Freakonomics Radio Network, the hidden side of everything.
    0:53:15 Stitcher.
    0:53:16 (upbeat music)
    0:53:18 you

    Every December, a British man named Tom Whitwell publishes a list of 52 things he’s learned that year. These fascinating facts reveal the spectrum of human behavior, from fraud and hypocrisy to Whitwell’s steadfast belief in progress. Should we also believe?

     

     

  • EXTRA: The Opioid Tragedy — How We Got Here

    AI transcript
    0:00:00 Hey there, it’s Stephen Dubner.
    0:00:06 We just finished a two part series that looked at the very long lasting opioid crisis.
    0:00:12 It’s horrible.
    0:00:13 It’s absolutely horrifying.
    0:00:15 We learned why the opioid epidemic has endured and we learned about the billions of dollars
    0:00:20 in settlement money and how that should be used.
    0:00:24 Don’t spend any money on anything some other funding stream covers.
    0:00:28 Today, we wanted to play for you a bonus episode.
    0:00:31 This is an update of a piece we published in early 2020, a piece that was also about
    0:00:37 the opioid crisis.
    0:00:39 As you will hear, the crisis seemed to be leveling off back then.
    0:00:43 But as it turned out, it wasn’t.
    0:00:45 It continued to worsen, especially during the pandemic, although there are signs that
    0:00:49 now it really is leveling off.
    0:00:53 In this episode, we spoke with some University of Pennsylvania physicians about an addiction
    0:00:58 treatment that they thought should be universal.
    0:01:01 They can get it as part of routine medical care, just like they might get their insulin
    0:01:05 for their diabetes or their blood pressure medicine.
    0:01:08 So is this treatment now universal?
    0:01:12 That’s probably a no.
    0:01:13 You’ll also hear a bit more from Stephen Lloyd, the Tennessee physician who was featured
    0:01:18 in our new series, and stick around to the end of this episode for an update on the team
    0:01:23 at Penn Medicine.
    0:01:25 As always, thank you for listening.
    0:01:47 We’ll see you there.
    0:01:56 Jean Marie Perron is a professor in the Department of Emergency Medicine at the University of
    0:02:01 Pennsylvania.
    0:02:02 I’m an emergency medicine physician and a medical toxicologist, which means I was trained
    0:02:07 in poisonings and overdoses.
    0:02:09 And more recently, I’ve started to do addiction medicine work.
    0:02:13 Perron has seen the opioid crisis up close as a researcher and a practitioner.
    0:02:18 So we have about 1,000 or 1,200 patients who visited our three hospitals last year,
    0:02:23 and about 400 of them were overdoses.
    0:02:26 Have you ever used opioids of any sort?
    0:02:28 No.
    0:02:29 Had a couple kids and broke my leg and broke my wrist.
    0:02:34 I didn’t have opioids for any of those three things.
    0:02:37 Were you offered in any case?
    0:02:38 I broke my leg in Canada, interestingly, I would say right in the middle of the opioid
    0:02:42 crisis.
    0:02:43 And they’d said, “Do you need anything?”
    0:02:45 And I said, “I’m fine with ibuprofen.”
    0:02:47 Skiing?
    0:02:48 Mountain biking.
    0:02:50 But anyway, I did bring it on myself.
    0:02:54 But I would definitely say that I would have a super high threshold for anyone in my family.
    0:02:59 Anyone I know.
    0:03:00 I mean, I advise against it sort of across the board.
    0:03:03 Because it’s just too easy to…
    0:03:05 It’s just that you just don’t need to go there.
    0:03:08 So opioid deaths in the U.S. have leveled off, maybe started to decline a little bit.
    0:03:13 What are you seeing here in Philadelphia?
    0:03:15 So they did decline a little bit.
    0:03:17 I think what is important about the national data is that the deaths that have declined
    0:03:22 the most are the oral pills.
    0:03:25 And that’s probably the result of deprescribing and a little bit of a result of prescription
    0:03:30 drug monitoring programs preventing the co-prescribing of benzodiazepines with opioids.
    0:03:35 A little bit more public awareness like I shouldn’t drink when I’m taking back pain medication.
    0:03:42 Another potential driver of the slight decline in deaths is the widespread availability of
    0:03:47 Narcan, an emergency nasal spray of the drug naloxone, which can stop an overdose as it’s
    0:03:53 happening wherever it’s happening.
    0:03:56 Perone has administered Narcan herself a few times.
    0:03:58 The most recent was riding the subway home in Philadelphia after a night out.
    0:04:04 And somebody called and said, “Does anyone have Narcan?
    0:04:07 There’s a man down.”
    0:04:08 And I do carry Narcan.
    0:04:10 And so I ran five or six subway cars up and there was a man on the ground.
    0:04:14 Getting CPR was blue, cyanotic, was pulseless, really on the brink of death or defined as
    0:04:21 dead already, maybe.
    0:04:22 And so we continued CPR, I got my Narcan out, I gave him one dose and he didn’t really
    0:04:27 respond and then I gave him another dose.
    0:04:30 And then I thought, you know, we needed to do mouth to mouth.
    0:04:32 And then I thought maybe some of the Narcan was still stuck in his nose and so I sort
    0:04:35 of scribbled his nose a little bit and kind of irritated him a little bit more.
    0:04:39 And then he took like one teeny, tiny breath and over the course of the next, you know,
    0:04:45 90 seconds, he started to wake up and then about 10 minutes later, EMS came.
    0:04:50 I was like, “You guys just saved this guy’s life.”
    0:04:52 You’re saying you guys, but you were the one that came with him.
    0:04:54 Well, no, but they had started CPR.
    0:04:56 They had called someone for help.
    0:04:57 They had called 911.
    0:04:58 I mean, they had done so much, you know, we simulate resuscitations like that in the hospital
    0:05:02 and this group of, you know, people just got it all together, did it, all the right thing.
    0:05:06 So it was really impressive.
    0:05:07 I mean, it was probably 25 or 30 people at the end of it all.
    0:05:10 And it was like this amazing, I call it my Philly moment because it was like winning
    0:05:14 the Super Bowl when everyone was in the streets and everyone just had this amazing bond.
    0:05:18 And it was just, it was incredible.
    0:05:19 It brought tears to my eyes then and it brings tears to my eyes when I talk about it.
    0:05:26 So that story had a happy ending.
    0:05:28 Many overdose stories do not, and Narcan can only do so much.
    0:05:33 It doesn’t treat the underlying addiction.
    0:05:36 The patients who come to the emergency department after receiving Narcan from an overdose, about
    0:05:41 6% of them are dead at the end of one year and 10% of them are dead at the end of two
    0:05:45 years.
    0:05:46 So there is no other medical condition that we currently treat in the emergency department
    0:05:49 that has that kind of mortality.
    0:05:51 So from your perspective, I’m curious, you’re an ER doc and people come in for help.
    0:05:58 They help when they’re in a desperate state already, right?
    0:06:01 They’re not typically coming to you to say, I’ve been thinking long and hard about my
    0:06:05 life and I want to make a graduated change, right?
    0:06:09 So what can you do for them?
    0:06:11 What was the treatment, let’s say five years ago when the problem was starting to really
    0:06:15 turn into a horror and how does the treatment differ now?
    0:06:20 So that’s a great question.
    0:06:21 Five years ago, an overdose patient hopefully got some compassion in the emergency department
    0:06:26 and a little bit of a conversation about why they may have overdosed that day or what we
    0:06:30 can do to help them.
    0:06:32 Maybe as of four or three years ago, they would have been discharged with a box of Narcan
    0:06:36 or naloxone so that if they were exposed to another overdose, somebody could use that
    0:06:40 on them or they could use it on a friend or colleague.
    0:06:44 I think fast-forwarding from there, what we’ve realized is that giving them kind of a crumpled
    0:06:49 piece of paper, it said you should stop using drugs, doesn’t really work.
    0:06:53 They’re in a cycle of using and fighting withdrawal every three or four hours.
    0:06:59 And so that doesn’t lend itself to getting your phone out and making an appointment from
    0:07:02 Monday morning to see an addiction specialist.
    0:07:08 This appointment model was failing in other hospitals too.
    0:07:11 We were on the front lines just seeing patients being brought in, sometimes being just dropped
    0:07:17 off at the door and thrown at the emergency personnel.
    0:07:22 Ms. Gail Denafrio.
    0:07:23 I am Professor and Chair of Emergency Medicine at the Yale School of Medicine.
    0:07:29 She is also Chief of Emergency Services at Yale New Haven Health.
    0:07:33 So like Perone, Denafrio is a practitioner and a researcher.
    0:07:38 So our study in JAMA in 2015 was looking at different models of care for opiate use disorder.
    0:07:44 JAMA is the Journal of the American Medical Association.
    0:07:48 And in 2015, ER practitioners like Denafrio weren’t having much success treating the
    0:07:54 many opioid addicts they’d started to see.
    0:07:56 So she and her team set up a study.
    0:07:59 It included 300 patients divided into three treatment groups.
    0:08:04 In the first group.
    0:08:05 We’ll try to motivate them to get care and then we’ll refer them to the centers of care
    0:08:11 that we had here at Yale or in the community.
    0:08:15 This was the standard treatment at the time, the crumpled piece of paper model that Jean
    0:08:19 Marie Perone mentioned.
    0:08:21 The second group of Denafrio’s patients got a bit extra.
    0:08:24 They got motivational enhancement, which we call the brief negotiation interview.
    0:08:30 That was a 15 minute conversation talking about their addiction and the circumstances
    0:08:35 that led to it.
    0:08:36 And then those people got a facilitator referral.
    0:08:40 Not just a crumpled piece of paper.
    0:08:42 So we actually called the place ourselves and if it was at night, we’d call them in
    0:08:46 the morning and said, we refer this person to you.
    0:08:49 And then the third group.
    0:08:50 They got also a motivational enhancement brief intervention.
    0:08:54 But then they were started on buprenorphine.
    0:08:59 So buprenorphine is a opioid agonist, which means it activates the opioid receptor just
    0:09:05 like heroin and oxycodone.
    0:09:09 Jean Marie Perone again.
    0:09:10 I think everyone knows methadone and methadone is our historically opioid agonist treatment
    0:09:17 that we use for patients with opioid use disorder and the only treatment we really had for a
    0:09:21 long time.
    0:09:22 But methadone has issues.
    0:09:24 Methadone is dispensed from federal treatment programs and the patient has to go there every
    0:09:28 single day to get their dose.
    0:09:31 And the opioid agonist methadone works by being a very long acting opioid and acting
    0:09:35 at the opioid receptor.
    0:09:36 And in high enough doses, it thwarts the use of other opioid agonists.
    0:09:42 Buprenorphine is different.
    0:09:43 First of all, it can be prescribed from a doctor’s office.
    0:09:45 So the patient doesn’t have to go to a methadone clinic every day.
    0:09:48 They can get it as part of routine medical care, just like they might get their insulin
    0:09:52 for their diabetes or their blood pressure medicine.
    0:09:55 And it’s intended to be less stigmatizing to get it as part of routine medical care.
    0:10:00 The other thing is that it’s a partial agonist at the opioid receptor, so it doesn’t continue
    0:10:04 to activate it the way methadone does.
    0:10:06 So that’s what we call a sealing effect, which makes it much safer so that there isn’t as
    0:10:11 much respiratory depression and there isn’t as much risk of opioid overdose and death.
    0:10:16 It’s really hard to overdose on it.
    0:10:19 It’s hard even if a child takes a pill of their adult family or friend and off a table
    0:10:26 that they will die from it, because it does eventually just reach that sealing effect.
    0:10:31 So buprenorphine, which is itself an opioid, would seem to offer a safer and more flexible
    0:10:37 treatment for opioid addiction.
    0:10:39 But how effective is it?
    0:10:42 That’s what Denofrio is really looking for in her study at Yale.
    0:10:46 And so what we found was that those patients that were in the buprenorphine group were
    0:10:52 two times more likely to be in formal treatment at 30 days in one month.
    0:10:59 That was a huge improvement over the two other groups in the study.
    0:11:04 So about 37% of patients in the referral group were in treatment, and about 45% in the brief
    0:11:11 intervention group, and then almost 80% in the buprenorphine group.
    0:11:16 So they were able to double the rate of engagement of patients who showed up for a follow-up
    0:11:21 meeting.
    0:11:22 When Jean Marie Perron of Penn saw the Yale study, she was impressed and excited.
    0:11:28 And that is so critical to getting people into treatment.
    0:11:34 And that medication stabilizes the cycle of withdrawal that patients are experiencing.
    0:11:39 So it’s really important to not say you can come in tomorrow for your first appointment,
    0:11:43 but here’s a medication.
    0:11:44 The next 12 hours won’t be the hell you think it’s going to be if you start on this medication
    0:11:48 now.
    0:11:49 So that sounds like a wildly useful drug that I’m sure every hospital and medical board
    0:11:54 and state legislature must be in favor of dispensing more of this antidote, yes?
    0:12:02 That’s probably a no.
    0:12:03 I think there’s a lot of good people in theory who do want to do this and expand our treatment.
    0:12:08 I think the logistics of learning how to administer buprenorphine sounds more complicated than
    0:12:13 it might be, and that is a barrier.
    0:12:15 What do you mean by the logistics of administering it?
    0:12:18 So first of all, in order to write a prescription for buprenorphine, you have to get something
    0:12:23 called an X-Waver, which means that you have to take an eight-hour training program, and
    0:12:28 you have to apply to the DEA to get a special waiver.
    0:12:31 Does the same sort of waiver licensing process apply to prescribing medical opioids in the
    0:12:36 first place?
    0:12:37 It does not.
    0:12:38 So I can, in fact, treat your opioid use disorder with oxycodone or hydromorphone if I wanted
    0:12:44 to, and that would be not regulated at all.
    0:12:48 So why the extra level of regulation for buprenorphine?
    0:12:53 It’s complicated, but when we went from the late ’60s when we started methadone, and we
    0:12:58 had people who needed treatment, but we weren’t going to let just any doctor prescribe it,
    0:13:02 and so that’s why methadone was restricted to these federal treatment programs.
    0:13:05 But then when we said, well, in 2000, buprenorphine became available and was approved in the
    0:13:11 United States, but we weren’t just going to let every doctor put out a shingle and start
    0:13:15 administering buprenorphine.
    0:13:19 Buprenorphine is most commonly administered in a name brand drug called suboxone, which
    0:13:24 also contains naloxone.
    0:13:27 Buprenorphine was invented by the pharma-firm Wreckett Benkeiser in 1966, one of many synthetic
    0:13:33 opioids designed in the 20th century.
    0:13:36 They were meant to treat pain, but be less addictive than opium itself.
    0:13:41 But as it turned out, most of them were addictive.
    0:13:44 That is the foundational problem of the prescription opioid crisis.
    0:13:48 In the 1990s, Wreckett Benkeiser recognized buprenorphine’s potential for treating opioid
    0:13:54 use disorder, and it spun off its buprenorphine division into what is now a subsidiary company
    0:14:00 called Indivior.
    0:14:02 Several years ago, another drug company thought about getting into the buprenorphine market,
    0:14:07 Purdue Pharma, which makes Oxycontin, one of the most widely abused prescription opioids.
    0:14:12 A Purdue memo at the time called buprenorphine an attractive market, but they never did
    0:14:18 jump in.
    0:14:19 Today, Purdue is the target of thousands of lawsuits charged with having downplayed the
    0:14:24 addictive nature of Oxycontin.
    0:14:27 Just how influential was Purdue in the opioid universe?
    0:14:31 Consider this startling development.
    0:14:33 The World Health Organization recently retracted its two main guidelines for using opioids
    0:14:39 to treat pain.
    0:14:41 Why?
    0:14:42 Because the guidelines, it has now been discovered, were unduly influenced by opioid manufacturers,
    0:14:48 including Purdue’s International subsidiary.
    0:14:51 And yet, at this moment, Oxycontin is still legally and widely dispensed as a useful painkiller
    0:14:58 that is also easily subject to abuse.
    0:15:01 Suboxone, meanwhile, is much harder to abuse, but is also harder to get.
    0:15:07 What do medical professionals who treat opioid addiction think of this?
    0:15:10 Here’s what one doctor wrote on the Health Affairs blog, “Buprenorphine has the potential
    0:15:16 to be a transformative tool in healthcare practitioners’ fight to reduce deaths from
    0:15:21 opioid overdose, but that the x-wavering process is onerous, outdated, and hampers our ability
    0:15:27 to help patients manage and recover from opioid addiction.”
    0:15:31 An editorial in JAMA Psychiatry made the same complaint and noted that easing the restrictions
    0:15:37 on buprenorphine in France helped drive down deaths from opioid overdose there by nearly
    0:15:43 80%.
    0:15:44 If extrapolated to the United States, the authors wrote, “This translates to more
    0:15:48 than 30,000 fewer annual deaths from opioid overdoses.”
    0:15:56 So globally, the statistics are tremendous, no doubt, in the evidence there.
    0:16:01 Do you see the waiver requirement for buprenorphine as a sort of overcorrection, overresponse
    0:16:08 to the medical community’s own embrace of opioids in the first place, like we messed
    0:16:14 up big time, and at the very least, what we’re not going to do now is mess up in the same
    0:16:20 direction, even though this might be a different direction?
    0:16:23 I think it lingers because of some of those concerns, but if we go back to 2000, we didn’t
    0:16:28 really have any kind of opioid crisis in 2000.
    0:16:31 So it was really approved in the absence of a big surge in opioid use at the time.
    0:16:36 I think not repealing it at this point is probably multifactorial.
    0:16:41 People are worried about suboxone diversion, so the same substance that we want to prescribe
    0:16:45 is also available on the street, and we acknowledge that.
    0:16:48 But it’s not used on the street to get high.
    0:16:51 It’s used for patients to treat their own withdrawal symptoms when they’re unable to
    0:16:55 get other medications.
    0:16:56 So I think that’s part of why there’s been some resistance to taking away the X-Waver.
    0:17:03 I think it also is going to take an act of Congress, which is fairly hard to accomplish.
    0:17:09 And I think that repealing the X-Waver isn’t entirely going to open the floodgates for prescribers
    0:17:14 who want to prescribe buprenorphine.
    0:17:15 There’s still some education and some stigma that needs to be addressed before more people
    0:17:21 are going to be willing to prescribe.
    0:17:24 This situation has changed somewhat since we first published this episode.
    0:17:29 In 2023, President Biden did sign a bill eliminating the federal requirement for doctors
    0:17:35 to obtain an X-Waver to prescribe buprenorphine, but some states still have their own restrictions
    0:17:41 on prescribing the medication.
    0:17:43 And that isn’t the only thing that’s keeping buprenorphine from being used more widely.
    0:17:48 If you look at residential treatment programs across the country, most of them, over 70%
    0:17:53 of them are still abstinence 12-step-based programs.
    0:17:56 That is Stephen Lloyd, a physician in Tennessee who specializes in addiction.
    0:18:01 Lloyd himself was addicted to prescription painkillers for years.
    0:18:06 “Basically, I took pills all day long.
    0:18:09 When I got out of bed in the morning, I had withdrawn during the night, so I was sweating.
    0:18:13 I felt like an 80-year-old man, and I was in my early 30s.”
    0:18:17 Lloyd went into a detox program and then a 30-day residential rehab facility, which
    0:18:22 got him turned around.
    0:18:23 Today, he’s the medical director for a network of addiction treatment centers.
    0:18:28 “I’m a big believer in medication-assisted treatment.
    0:18:31 And we know that the most effective thing that we can do for opioid addiction is actually
    0:18:35 medication-assisted treatment with the use of drugs like buprenorphine, methadone, and
    0:18:40 naltrexone.
    0:18:41 And I’ve taken heat from this in the local treatment community as well as the treatment
    0:18:46 community statewide and even nationally.”
    0:18:47 Can you just describe where that pushback and that reluctance is coming from?
    0:18:53 “Well, unfortunately, Stephen, the pushback comes from people in the recovery community.
    0:18:57 And one of the problems with addiction medicine is that most of the people that work in the
    0:19:01 field or a lot of the people that work in the field had to issue themselves.
    0:19:04 That’s how they got in the field, like myself.
    0:19:07 But they believe that the only way to get healthy is how they got healthy.
    0:19:10 So it’s totally anecdotal.”
    0:19:16 As Lloyd noted, most addiction treatment programs do stress total abstinence, including 12-step
    0:19:22 programs like Alcoholics Anonymous and Narcotics Anonymous.
    0:19:26 How successful are such programs?
    0:19:29 That is a famously difficult question.
    0:19:32 Solid data are hard to come by.
    0:19:34 After all, anonymity is a feature of such programs and there are all kinds of possible
    0:19:39 selection biases.
    0:19:41 Alcoholics Anonymous claims that 75% of its participants stay sober.
    0:19:46 But academic studies put the success rate closer to 10% or even less.
    0:19:51 That said, one Stanford study compared addicts who quit with the help of AA versus those
    0:19:56 who quit on their own and found that AA nearly doubled the success rate.
    0:20:01 Stephen Lloyd’s argument is that abstinence is the chosen path for the recovery community,
    0:20:07 but that medical professionals embrace MAT, medication-assisted treatment.
    0:20:11 “You’ve got the World Health Organization, you’ve got NIDA.”
    0:20:15 That is the National Institute on Drug Abuse.
    0:20:17 “Everybody who looks at this says the role of medication is paramount.
    0:20:22 It should be the cornerstone yet it’s so hard to get people into those programs because
    0:20:27 of the stigma associated.
    0:20:28 A lot of times it will be from parents.
    0:20:30 I’ve had numerous parents talk their kids out of medication because they said they were
    0:20:34 trading one drug for another and then a few months down the road I get the call that they’ve
    0:20:38 overdosed and died and I can’t tell you how heartbreaking those calls are.”
    0:20:42 If I say to you, I don’t like the idea of the pharmaceutical industry being able to
    0:20:47 be the chief beneficiary of medication-assisted treatment because they helped drive this problem
    0:20:54 in the first place.
    0:20:55 It’s a little bit like, you know, I set a house on fire and then I’m the hero who calls
    0:21:00 in the fire to the fire department.
    0:21:01 I don’t like the optics of that, I don’t like the economics of that.
    0:21:05 What do you say to that argument?
    0:21:06 I have to say, I agree with you a million percent.
    0:21:08 It makes me choke every time I think about it, but I don’t have a better option.
    0:21:13 I don’t have anything else that’s going to stop my patients dying at the rate that
    0:21:17 MAT does.
    0:21:18 I can’t stand it.
    0:21:19 I read somewhere recently that several years back Purdue Pharma tried to acquire the marketing
    0:21:25 rights to buprenorphine, which just absolutely is unconscionable to me, and so I would agree
    0:21:31 with you one thousand percent.
    0:21:32 I wish there was a better option, but right now there’s not, and so I can’t let my feelings
    0:21:38 get in the way of trying to help my patients and help them stay alive.
    0:21:43 Could you describe for me the underlying causes of opioid addiction?
    0:21:47 I guess what I’m looking for is if you could break it down between a physiological addiction
    0:21:52 or craving, as well as the psychological and environmental drivers.
    0:21:57 Well, I don’t know how much more I need to break it down.
    0:22:00 You just did.
    0:22:01 You know, that’s the classic biopsychosocial model that you just described.
    0:22:04 So that’s really the three big components of developing any addiction, in this case opioids.
    0:22:09 So I teach it in terms of a slot machine, you know, when the three sevens come down
    0:22:13 on the pay line, that’s when the money comes out.
    0:22:16 So the first seven is the bio component, and that’s simply genetics.
    0:22:19 Do you have a family history of any addiction?
    0:22:22 If you do, then that first seven comes down on the pay line, and addiction is about sixty
    0:22:27 percent genetic for the most part.
    0:22:29 The second part is the psychological component.
    0:22:32 What kind of household are you raised in?
    0:22:34 Do you have a high ASA score, adverse childhood experiences, where you physically, sexually,
    0:22:39 you’re emotionally abused?
    0:22:40 Do you have that chronic trauma maybe even later in your life?
    0:22:43 If you do, then that second seven is down on the pay line.
    0:22:46 And then the third seven is the social component, and that’s just the availability.
    0:22:50 You know, what is widely available?
    0:22:52 And the thing that’s most widely available and accepted is alcohol, and that’s still
    0:22:56 mostly what we see people abusing and addicted to.
    0:23:00 But in the late 1980s, early 90s, and into the 2000s, opioids became much more widespread.
    0:23:07 You and many others call addiction generally a disease.
    0:23:11 And it sounds like the factors that may determine your likelihood for the disease are pretty
    0:23:16 much everywhere.
    0:23:18 So do you see this as a different sort of disease than we typically think about with epidemiology?
    0:23:26 Let’s take a disease that everybody agrees on, type two diabetes mellitus.
    0:23:29 You know, nobody has a problem with type two diabetes being a disease, right?
    0:23:33 I never hear any discussion about that yet for the most part, it’s behavioral, right?
    0:23:37 Why do people get type two diabetes?
    0:23:38 Well, they don’t eat right and they don’t exercise correctly.
    0:23:42 And so we treat that widely with medication to try to decrease the bad outcomes with diabetes.
    0:23:47 So you know, I look at addiction as being much the same.
    0:23:51 If you know about addiction, addiction is a brain disease.
    0:23:55 Gildanofriogen from Yale.
    0:23:57 And we know by looking at scans of the brain that even though I maybe have had treatment
    0:24:04 and I’m no longer physically dependent, the minute you show me something, whether it’s
    0:24:09 a syringe or it could be just a place that I used, parts of my brain might make a little
    0:24:15 light up, showing that I still have this craving.
    0:24:20 I still have this possibility to use if I get back in that situation.
    0:24:25 I can’t pray myself out of it.
    0:24:28 I can’t will myself out of it.
    0:24:30 So it doesn’t matter if I call it a disease or a learning disorder.
    0:24:33 It is a rewiring of the brain, the reward system in the frontal lobe interaction, and to where
    0:24:37 the primary focus becomes acquisition of this substance for me to be okay.
    0:24:42 And so when I look at it in those terms, it looks a lot like diabetes to me.
    0:24:46 Can you talk for a minute about federal policy toward medication assisted treatment and perhaps
    0:24:52 buprenorphine specifically, from what I’ve read the policy recommendations during the
    0:24:56 Trump administration have been evolving very rapidly?
    0:25:00 If you look at, you know, President Trump’s first appointment to the head of Department
    0:25:04 of Health and Human Services was Dr. Tom Price.
    0:25:06 He came out early on and said, “Well, you know, this is simply switching one drug for
    0:25:10 another.”
    0:25:11 And those of us in the addiction field had serious angst about that, but you have folks
    0:25:15 in HHS right now that are giving really good direction with regards to medication assisted
    0:25:20 treatment and making it more widely available.
    0:25:23 It is evolving quickly, and I think we’re to the point now that some of the stigma is
    0:25:27 being decreased simply because so many people have died.
    0:25:31 Instead of defining recovery as total abstinence from any medication, I want to define recovery
    0:25:36 in those parameters of, is your life getting better?
    0:25:39 Are you still going to jail?
    0:25:40 Do you have your kids back?
    0:25:41 Do you have a job?
    0:25:43 Are you a member of the tax-paying citizenship of the United States?
    0:25:46 To me, those are much more reflective of effective treatment than whether or not somebody is
    0:25:50 totally abstinent from all drugs because some 12-step group says they have to be.
    0:25:57 Stephen Lloyd’s philosophy, as well as that of Gail Denafrio and Jean-Marie Perron, falls
    0:26:02 under the umbrella of what is called harm reduction.
    0:26:04 It’s the idea that you treat risk, not as something that must be driven to zero.
    0:26:09 In a recent episode called “The Truth About the Vaping Crisis,” we talked about the battle
    0:26:14 between smoking abstentionists, people who argue that nobody should be consuming any
    0:26:19 nicotine in any form, and harm reductionists who argue that vaping may carry risks, but
    0:26:25 they’re almost certainly smaller than the risks from smoking cigarettes.
    0:26:29 When it comes to opioid abuse, the gap between the abstentionists and the harm reductionists
    0:26:35 seems to be even wider.
    0:26:37 Why is that?
    0:26:38 What’s different about opioids?
    0:26:40 It’s always been stigmatized.
    0:26:41 I don’t know why.
    0:26:43 I think any time you lessen the stigma associated with addiction, you increase people’s opportunity
    0:26:48 to step out of the shadows and ask for help.
    0:26:52 After the break, how that help happens, when it happens, and we talked to two addicts
    0:26:57 in recovery, one of whom now works at the University of Pennsylvania Hospital, helping
    0:27:02 other addicts break the grip.
    0:27:04 You’re listening to Freakinomics Radio.
    0:27:06 I’m Stephen Dovner, we’ll be right back.
    0:27:22 As we’ve been hearing, treating opioid addiction with another opioid like buprenorphine is
    0:27:28 not a concept that is universally embraced, but a lot of smart and dedicated people are
    0:27:35 in favor, including Jean-Marie Perron, a medical researcher and ER doctor at the University
    0:27:40 of Pennsylvania.
    0:27:42 She and her team have been creating a new treatment protocol for opioid addiction that
    0:27:47 includes buprenorphine or suboxone, but more than just that.
    0:27:51 They are changing the way addicts are treated from the moment they wind up in the ER.
    0:27:56 This treatment includes what they call a warm handoff.
    0:28:00 So a warm handoff is a newish term, is the idea that a patient at a hospital or a clinic
    0:28:06 is going to be discharged having already met a peer or someone who’s going to either accompany
    0:28:10 them to an appointment, or they’ve met the doctor or clinician who will take care of
    0:28:15 them, so that there’s a close connection between the patient and the patient’s next
    0:28:19 step in recovery.
    0:28:21 And there’s another member of the warm handoff team, a peer counselor.
    0:28:26 Our peer counselors are people who are in recovery themselves and who can start the
    0:28:29 dialogue right there and about what it would look like if they tried medication or tried
    0:28:36 to get into a treatment program or tried to engage in care right then.
    0:28:40 It’s all about engagement.
    0:28:42 These peer counselors are on staff at the hospital.
    0:28:44 They’ve gone through certification training and they’ve got first hand experience as opioid
    0:28:50 addicts.
    0:28:51 I think they’re some of the most, not just dedicated, but people who have been through
    0:28:57 more than I’ve ever been in my super easy life and who have come to the other side and
    0:29:02 who want to help other people and who are successful at helping other people.
    0:29:06 They’re special.
    0:29:07 People like Nicole.
    0:29:08 People like Nicole.
    0:29:09 Absolutely.
    0:29:10 I am Nicole O’Donnell and I’m a certified recovery specialist in emergency rooms at
    0:29:15 Penn.
    0:29:16 So Nicole, what’s your story?
    0:29:18 How’d you get to be in this position?
    0:29:20 So from using to here, there was a lot of work.
    0:29:24 So my first love was Bendos, which was Xanax.
    0:29:27 That’s what I became addicted to.
    0:29:30 I went to rehab.
    0:29:31 I was 21.
    0:29:32 My first time, I went to treatment, inpatient treatment and it worked.
    0:29:36 It worked for about two years and then there was opioid painkillers around.
    0:29:43 So that’s, you know, why not, right?
    0:29:46 And then oxycontins weren’t really as readily available then.
    0:29:52 So it was like perk 30s and opiates that were, you know, someone’s prescription that we got.
    0:29:59 And then they are very expensive.
    0:30:02 So it was easier to get heroin.
    0:30:06 And then what happened?
    0:30:07 How’d you finally get clean?
    0:30:10 I was tired of stalling withdrawal because that’s all I was doing in the end was using
    0:30:15 so I wasn’t in withdrawal, right?
    0:30:17 So I came to this realization that I’m going to continue to be in withdrawal every single
    0:30:23 time until I do something about it because the withdrawal is awful and nobody wants to
    0:30:27 be in it.
    0:30:28 And I realized my life was trying to figure out how I was getting drugs just to stop withdrawal.
    0:30:33 It’s not fun in the end.
    0:30:34 It’s not a party.
    0:30:35 Nobody’s happy.
    0:30:36 You know, you’re just really trying not to be sick and barely functioning.
    0:30:41 You had a sister?
    0:30:42 Yes.
    0:30:43 Yes.
    0:30:44 One.
    0:30:45 She was younger than me.
    0:30:46 Jessica.
    0:30:47 Yeah.
    0:30:48 And I understand she died of an overdose.
    0:30:49 She did.
    0:30:50 And it was December 14th of 14.
    0:30:53 Okay.
    0:30:54 And what were her drugs or drugs?
    0:30:56 Heroin.
    0:30:57 And what was your relationship like with her then?
    0:30:59 We used together.
    0:31:00 Yeah.
    0:31:01 She gave me heroin for the first time.
    0:31:04 So I was doing restaurant management for the first seven years of my recovery and then
    0:31:08 I lost my sister.
    0:31:09 And that’s when I started doing outreach.
    0:31:12 I needed to give her death purpose and I needed to maybe be the person for people that she
    0:31:18 probably didn’t encounter in her active addiction.
    0:31:23 O’Donnell introduced me to one of the people that she’s been helping.
    0:31:27 My name’s Eileen Richardson.
    0:31:29 I am a restaurant manager.
    0:31:31 I’m also an alcoholic and an addict.
    0:31:34 I’m from the Jersey Shore originally.
    0:31:37 New to Philadelphia.
    0:31:38 I’ve been here a little over a year now.
    0:31:41 I’m married.
    0:31:42 I have a wife.
    0:31:43 I have a son.
    0:31:44 He just turned three.
    0:31:45 Congratulations.
    0:31:46 What’s his name?
    0:31:47 His name is Henrik, or Henrik Matthew Richardson as he likes to say.
    0:31:50 On the day we spoke, Richardson had been in recovery for 93 days.
    0:31:54 She had come into the pen ER after overdosing.
    0:31:58 And Nicole came to meet me in the hospital.
    0:32:01 I believe it was the physician that I saw asked me if I was interested in getting help.
    0:32:06 And he said he had somebody he knew that I could talk to and Nicole showed up to talk
    0:32:11 to me.
    0:32:12 Yeah.
    0:32:13 You overdosed on what?
    0:32:14 On heroin and fentanyl.
    0:32:17 Nicole helped Eileen get on Suboxone.
    0:32:20 I’m still doing the Suboxone.
    0:32:22 I take it every day.
    0:32:24 The Suboxone helps.
    0:32:25 I don’t have cravings.
    0:32:26 And right away that started.
    0:32:28 When I went back in the second time to the Suboxone clinic, the recent time, they upped
    0:32:33 my dose.
    0:32:34 And from that day on, I haven’t had a single craving for any opiate sense.
    0:32:40 What’s that feel like?
    0:32:41 Pretty awesome.
    0:32:42 I’m pretty amazing.
    0:32:43 So how much of your success would you attribute to working with Nicole and having a peer who
    0:32:50 understands it, the drug itself, and then any other third or fourth reason?
    0:32:55 I mean, they all play a big part.
    0:32:57 I wouldn’t want to break it into percentages or graphs or anything like that because for
    0:33:01 me, it’s all intertwined.
    0:33:03 But do you think that Nicole without the Suboxone would do it?
    0:33:07 No.
    0:33:08 The Suboxone is definitely something I needed.
    0:33:11 But if I was just doing the Suboxone and nothing else, I would stop taking the Suboxone.
    0:33:17 I wouldn’t keep taking it.
    0:33:19 The drug helps the physical part.
    0:33:21 And then everything else I do helps me become a new person, a new human being, which is
    0:33:26 my goal.
    0:33:27 So the Suboxone helps you get back to the level that Nicole can work there.
    0:33:34 Exactly.
    0:33:35 Yeah.
    0:33:36 Yeah.
    0:33:37 In my belief, yeah.
    0:33:38 Suboxone sounds like a really good solution, at least for some of the people some of the
    0:33:42 time.
    0:33:43 Right?
    0:33:44 Can you talk about, I guess, the problem or the barrier of being able to use it as widely
    0:33:48 as it might ought to be used?
    0:33:50 So from my perspective, aside from the X-weavering and the medical barriers that the doctors
    0:33:57 experience, from our experience too, is there’s a big stigma with it in the recovery community?
    0:34:04 The recovery community traditionally has been abstinence-based, and that means nothing.
    0:34:10 No medications, no illicit drug use, nothing.
    0:34:13 How come?
    0:34:15 It’s just this deep-seated thing.
    0:34:18 The 12-step programs, there’s a lot of tradition and stuff like that, and there’s not a lot
    0:34:23 of change.
    0:34:24 And I’m not going to lie.
    0:34:26 I love the 12 steps, and I love the program, and it’s done so much for me.
    0:34:30 But I don’t talk about the fact that I use Suboxone.
    0:34:33 My sponsor knows.
    0:34:35 My close friends know, but I don’t bring it up in meetings.
    0:34:38 And there’s different 12-step programs, obviously, and one of them specifically states that MAT
    0:34:45 is not considered clean.
    0:34:47 Eileen, right before we started recording, you told us that a friend of yours just died
    0:34:53 just now.
    0:34:54 Yeah.
    0:34:55 I don’t know how much you want to say about those circumstances.
    0:34:59 It’s a friend you knew for how long and how’d they die?
    0:35:02 I have known him since I started going to the 12-step group that I go to, what we call
    0:35:09 our home group, back in February.
    0:35:12 He was coming up on a year sober in 18 days.
    0:35:16 He would have had a year, and how it happens is that people stop, and then they go back
    0:35:24 out and they think they can use the same amount that they were using once before, and you
    0:35:29 just can’t anymore.
    0:35:31 You’re pretty much killing yourself if you go back out.
    0:35:34 Not people always close to me, but I know someone that’s dying every week, but I was
    0:35:40 with him yesterday, and we were talking and joking about the fishing trip that we’re going
    0:35:45 on next week, and his mom was just talking to him on Facebook about how proud she was
    0:35:53 of him, and it’s a horrible disease.
    0:35:56 Who’s heroin?
    0:35:59 Really heroin and fentanyl, everything’s fentanyl now.
    0:36:06 The opioid crisis really began with prescription pills, then moved into heroin, and now synthetic
    0:36:12 fentanyl, which presents a particularly high risk of overdose.
    0:36:16 To that end, there is another idea currently under consideration in Philadelphia.
    0:36:20 We’re all harm reductionists here.
    0:36:23 Nicole O’Donnell again, the certified recovery specialist.
    0:36:26 So we advocate for safe injection practices, the needle exchange, but there’s this safe
    0:36:35 house that we’re all advocating for, and it’s a place to go for people to safely not overdose.
    0:36:41 They go use, drugs get tested, they have medical staff, they have peers, hopefully, there to
    0:36:48 navigate them into treatment the same way we do in the emergency room.
    0:36:52 The legal official kind of safe drug use site that O’Donnell is describing doesn’t exist
    0:36:58 yet, at least not in Philadelphia.
    0:37:00 Two sites have been approved in the US, one in New York City, which is up and running,
    0:37:05 and one in Providence, Rhode Island, which is still in development.
    0:37:09 Sites like this also exist in several Canadian cities.
    0:37:12 The safe house nonprofit is backed by many local and state officials, but it has faced
    0:37:17 pushback from the US Justice Department.
    0:37:20 Things today don’t look promising.
    0:37:23 A federal court recently ruled against safe house in a multi-year case against the Justice
    0:37:29 Department.
    0:37:30 My point of advocacy for safe house is for people like your friends that just passed,
    0:37:36 because he’s in recovery, right?
    0:37:37 If I use, I’m going to die.
    0:37:39 Fortunately, through my years of, you know, this advocacy, I have a person, I have a safe
    0:37:45 house.
    0:37:46 I have a person that I would call if I didn’t want to die to make sure I didn’t overdose
    0:37:50 if I used.
    0:37:51 I have that.
    0:37:52 That’s a safety net, right?
    0:37:53 Not everyone has that.
    0:37:54 So this is a place that we want people to be able to go like your friends.
    0:37:59 If he was at this place, he wouldn’t have died.
    0:38:02 The opposite of addiction is not recovered.
    0:38:04 The opposite of addiction is community and relationship.
    0:38:07 You can’t have community if you’re dead.
    0:38:10 Dr. Stephen Lloyd again.
    0:38:12 So the first thing is to keep patients alive.
    0:38:14 Now, the longer that we keep them alive, the more that we need to be able to engage them
    0:38:19 in supportive environments around really everything.
    0:38:22 And what’s your position on, I guess, legal dispensaries of illegal drugs?
    0:38:28 And I’m curious if there’s any movement toward that in Tennessee.
    0:38:32 You’re really putting me in a position to get in trouble.
    0:38:34 I think we have to look at this point at all harm reduction strategies.
    0:38:38 So I think anytime you lessen the stigma associated with addiction, you increase people’s opportunity
    0:38:43 to step out of the shadows and ask for help.
    0:38:45 And I’m for any modality that gets people to that point.
    0:38:51 The warm handoff program at UPenn is still relatively new.
    0:38:55 I asked Nicola O’Donnell, the recovery specialist, how many patients she will see in a given
    0:39:00 day.
    0:39:01 In an average day, we could see up to six people.
    0:39:04 I mean, whether they’re inpatient for a medical reason, inpatient in our inpatient
    0:39:10 drug and alcohol treatment or they’re through the emergency room.
    0:39:13 One of those six, how many are willing to at least have a conversation with you about
    0:39:18 medication assisted therapy?
    0:39:20 Honestly, there’s not many that say they don’t want to talk.
    0:39:24 Whether they want things or not, it’s a different story, you know, then we have a harm reduction
    0:39:28 conversation.
    0:39:29 But nobody really throws you out of the room and says, I don’t want to talk about anything.
    0:39:41 So if there’s one misperception about opioids, about use, abuse, whatever, that many people
    0:39:51 like public radio nerds who are going to listen to this, if there’s one thing they really
    0:39:55 don’t know, what would you want to tell people?
    0:39:59 That opiate use disorder is treatable.
    0:40:01 It’s not a death sentence.
    0:40:03 It’s not, you know, it’s a medical condition and it’s treatable.
    0:40:07 It sounds so simple when you say it that way, but there’s all this conversation going on
    0:40:12 around the topic now in the political community and it’s never said that simply.
    0:40:17 Why not?
    0:40:18 Because we like to overcomplicate things and it really doesn’t need to be overcomplicated.
    0:40:23 Eileen takes her medication, she engages and she goes to meetings and she’s doing amazing
    0:40:28 and she’s a mom to her son, right?
    0:40:32 It’s treatable.
    0:40:33 We don’t have to overcomplicate it.
    0:40:41 That was our report on the opioid crisis from 2020.
    0:40:45 We recently reached out to the team at Penn for an update.
    0:40:49 Here’s what Dr. Perrone told us.
    0:40:51 Our program has grown substantially since we last spoke.
    0:40:54 We started a new center at Penn called the Center for Addiction Medicine and Policy and
    0:40:59 have multiple grants to sustain our work.
    0:41:03 Freakonomics Radio is produced by Stitcher and Renbud Radio.
    0:41:06 You can find our entire archive on any podcast app also at Freakonomics.com where we publish
    0:41:11 transcripts and show notes.
    0:41:13 This episode was produced by Zak Lipinski.
    0:41:16 Our staff also includes Alina Cullman, Augusta Chapman, Dalvin Aboulagi, Eleanor Osborn,
    0:41:21 Elsa Hernandez, Gabriel Roth, Greg Rippin, Jasmine Klinger, Jeremy Johnston, Julie Canfer,
    0:41:26 Lyric Bowditch, Morgan Levy, Neal Coruth, Rebecca Lee Douglas, Sarah Lilly, and Teo Jacobs.
    0:41:32 Our theme song is “Mr. Fortune” by the Hitchhikers and our composer is Louise Guerra.
    0:41:37 As always, thank you for listening.
    0:41:54 Stitcher.
    0:41:55 (upbeat music)
    0:41:57 you

    An update of our 2020 series, in which we spoke with physicians, researchers, and addicts about the root causes of the crisis — and the tension between abstinence and harm reduction.

     

    • SOURCES:
      • Gail D’Onofrio, professor and chair of emergency medicine at the Yale School of Medicine and chief of emergency services at Yale-New Haven Health.
      • Keith Humphreys, professor of psychiatry and behavioral sciences at Stanford University.
      • Stephen Loyd, chief medical officer of Cedar Recovery and chair of the Tennessee Opioid Abatement Council.
      • Nicole O’Donnell, certified recovery specialist at the University of Pennsylvania’s Center for Addiction Medicine and Policy.
      • Jeanmarie Perrone, professor of emergency medicine at the University of Pennsylvania.
      • Eileen Richardson, restaurant manager.

     

     

  • 590. Can $55 Billion End the Opioid Epidemic?

    AI transcript
    0:00:00 (dramatic music)
    0:00:02 When I say the opioid crisis or the opioid epidemic,
    0:00:08 you probably say enough already.
    0:00:12 I understand, you are sick of hearing about it.
    0:00:15 We are more than 25 years in
    0:00:17 if you use the introduction of OxyContin
    0:00:20 as the onset of this crisis,
    0:00:21 which most smart people in the field do.
    0:00:24 OxyContin is a powerful medical pain reliever
    0:00:27 that its manufacturer, Purdue Pharma,
    0:00:30 promised would not addict its users
    0:00:32 away other opioids can.
    0:00:33 This was a big deal
    0:00:35 since many millions of people seek out pain relief,
    0:00:38 whether intermittently or regularly.
    0:00:41 But that non-addictive promise, it turned out to be wrong.
    0:00:46 Addiction to OxyContin,
    0:00:47 and then similar drugs from other pharma firms,
    0:00:51 spiraled into a public health catastrophe.
    0:00:54 In 2023, 81,000 people in the US died from an opioid overdose,
    0:00:59 more than 10 times the number in 1999.
    0:01:03 So the problem has continued to worsen.
    0:01:06 Many of the current overdoses
    0:01:08 aren’t from prescription drugs like OxyContin,
    0:01:10 but from black market versions
    0:01:12 or from other drugs that contain fentanyl.
    0:01:15 That’s another synthetic opioid
    0:01:17 that began as a medical drug,
    0:01:20 and which is far more powerful than most opioids.
    0:01:23 Fentanyl has now worked its way into the supply
    0:01:26 of street drugs in the US,
    0:01:28 most of it smuggled across the Mexican border
    0:01:31 by American citizens.
    0:01:34 A great many people,
    0:01:35 policymakers, medical professionals and regulators,
    0:01:38 parents, law enforcement,
    0:01:40 they’ve all spent the past few decades
    0:01:42 trying to end the opioid crisis,
    0:01:44 but without much success.
    0:01:46 So as sick as you may be of hearing about it,
    0:01:50 imagine being the parent of someone who died from fentanyl
    0:01:53 or the husband or the child.
    0:01:56 Although you might not have to imagine,
    0:01:59 you probably know someone
    0:02:01 who’s experienced this kind of tragedy.
    0:02:03 It’s that common.
    0:02:05 Last week in part one of this two-part series,
    0:02:08 we asked a simple question, why?
    0:02:10 Why is the opioid crisis still raging after all these years?
    0:02:15 There are actually a lot of correct answers to that question.
    0:02:19 Here’s one.
    0:02:20 So it looks like it’s spreading through social networks,
    0:02:24 areas of the country that have more Facebook friends.
    0:02:26 Those areas also have more deaths.
    0:02:28 Sometimes the physical product will spread through networks
    0:02:32 and sometimes just the idea,
    0:02:34 oh, when I was in pain, I got this opioid
    0:02:37 and maybe you should try this opioid.
    0:02:39 That was David Cutler, a health economist at Harvard.
    0:02:42 We also heard last week from Keith Humphries,
    0:02:44 a drug researcher and policy advisor at Stanford.
    0:02:48 Humphries thinks that part of the blame goes to advocates
    0:02:50 who want to make drugs easier to get
    0:02:52 and want to remove the stigma of drug use.
    0:02:56 The faith that the advocates had
    0:02:58 that if you removed all pressure
    0:03:00 and you removed all shame from, you know,
    0:03:04 sitting on a park bench using fentanyl,
    0:03:06 then people would seek out care,
    0:03:09 proved to be completely incorrect.
    0:03:11 Today on Freakonomics Radio, a dissenting voice
    0:03:15 who thinks that shame is a big part of the problem.
    0:03:18 Sometimes I feel like I’m working
    0:03:20 in the days of the Salem Witch trials.
    0:03:22 Also, billions of settlement dollars
    0:03:25 have started to flow from the pharmaceutical firms,
    0:03:29 although not Purdue Pharma,
    0:03:30 yet they are still fighting over a bankruptcy plan.
    0:03:33 How the states are spending that money
    0:03:36 is not always transparent.
    0:03:39 Observers say this is not only a moral travesty.
    0:03:42 It’s also a travesty from a data perspective
    0:03:45 because we’re just going to have no sense
    0:03:47 of how these monies were actually spent.
    0:03:50 Why is the opioid epidemic still raging?
    0:03:53 Part two begins now.
    0:03:55 This is Freakonomics Radio,
    0:04:10 the podcast that explores the hidden side of everything
    0:04:13 with your host, Stephen Dubner.
    0:04:16 Stephen Lloyd is a physician in Nashville, Tennessee.
    0:04:29 The U.S. has more fatal drug overdoses per capita
    0:04:32 than any other country in the world,
    0:04:34 and within the U.S., Tennessee is right near the top,
    0:04:37 along with West Virginia, the District of Columbia,
    0:04:40 Delaware, and Louisiana.
    0:04:42 Lloyd works as an addiction recovery specialist,
    0:04:45 and he is chair of the Opioid Abatement Council of Tennessee,
    0:04:49 which helps direct the settlement money
    0:04:51 that is being dispersed to states.
    0:04:53 We first spoke with Lloyd several years ago
    0:04:55 for an earlier series we did on the opioid crisis.
    0:04:59 Here’s what Lloyd was advocating for back then.
    0:05:03 I think anytime you lessen the stigma
    0:05:05 associated with addiction,
    0:05:07 you increase people’s opportunity
    0:05:08 to step out of the shadows and ask for help.
    0:05:10 So when we got back in touch with Lloyd now,
    0:05:13 I asked if the stigma has declined.
    0:05:16 He says no.
    0:05:18 The opioid crisis has affected everybody
    0:05:20 from politicians’ sons to people who are unhoused.
    0:05:24 And so you would think that the stigma
    0:05:26 would be easier to break here, but it just hasn’t.
    0:05:28 I went back and looked to find the first doctor
    0:05:30 in the United States that described addiction
    0:05:33 as a disease and not a moral failure.
    0:05:34 It was actually Benjamin Rush.
    0:05:36 And he did it before 1776.
    0:05:39 So we’ve known for a really long time
    0:05:41 that this is not a moral failure,
    0:05:43 but it’s still the predominant thought out there right now.
    0:05:46 I don’t know how to break through that.
    0:05:47 – Lloyd is the chief medical officer
    0:05:49 for a chain of clinics called Cedar Recovery.
    0:05:52 Most of their funding comes from the federal government.
    0:05:55 – We do outpatient treatment of people
    0:05:57 with opioid use disorder.
    0:05:58 – I realize this is gonna sound flip,
    0:06:00 but I would guess business is booming, unfortunately, yes?
    0:06:03 – Yeah, sadly, and I’m with you.
    0:06:05 I hope one of these days to be out of business,
    0:06:07 but yes, unfortunately,
    0:06:08 it’s growing faster than any of us would like.
    0:06:10 If I make it till July 8th of this year,
    0:06:12 I’ll be 20 years in recovery myself.
    0:06:14 – Congratulations.
    0:06:15 – You know, a unique spin with not only being a doctor,
    0:06:18 but a doctor who was addicted earlier in his career
    0:06:21 to the very drugs that started all this
    0:06:23 with pain pills and really the drug OxyContin.
    0:06:25 – Does that give you an advantage
    0:06:27 as a physician in this kind of treatment mode?
    0:06:29 – I sure think so because I’ve been there.
    0:06:31 I’ve stolen pills out of people’s medicine cabinets.
    0:06:34 I’ve been dope sick more times than I can shake a stick at.
    0:06:36 So when somebody comes in to me
    0:06:38 and I can see that they’re in withdrawals,
    0:06:40 it’s not something I blow off.
    0:06:42 – Do you tell them about your background
    0:06:44 and how does that affect your treatment of them?
    0:06:46 – Most of the time, they know coming in,
    0:06:48 but I always lead off with it
    0:06:50 because one of the hardest things to do
    0:06:51 is overcome the shame and the stigma.
    0:06:53 So I just let them know that their doctor’s been there
    0:06:55 and I had to overcome the same things.
    0:06:57 – When you look at what’s been happening
    0:07:00 with opioid abuse and opioid overdose death
    0:07:03 in the last several years since we first spoke,
    0:07:07 I never would have predicted
    0:07:08 it would have continued to rise like it has.
    0:07:11 What’s your best assessment,
    0:07:14 whether it’s opinion or informed by data
    0:07:17 of why there’s still so much opioid overdose and abuse?
    0:07:21 – I think the last time we talked was four or five years ago
    0:07:24 and I’m with you,
    0:07:25 but I don’t think either one of us saw COVID-19
    0:07:28 and COVID really changed the landscape
    0:07:31 because if you think about addiction
    0:07:32 and realizing that the solution is community
    0:07:35 and relationship, it’s about connection.
    0:07:37 And then look at how we treated COVID
    0:07:39 and I’m not saying things were done wrong.
    0:07:41 We were all isolated, right?
    0:07:42 We were in our homes, we were working from home,
    0:07:43 we weren’t interconnecting.
    0:07:45 I knew that it was gonna kill our folks and it did.
    0:07:48 Overdose rates in the South were up between 40 and 50%.
    0:07:51 Any state you looked at.
    0:07:52 So when you and I first talked, I never saw this,
    0:07:54 but of course I didn’t see COVID-19.
    0:07:56 – Do you feel it’s plateaued?
    0:07:58 – I’m hoping, you know, I work in a lot of states
    0:08:00 and so I’m starting to see some evidence of some plateauing.
    0:08:03 I know that here in Tennessee, it does look like that,
    0:08:06 but even if we spend our open abatement dollars
    0:08:08 very, very wisely, it’ll take at least until the year 2046
    0:08:12 to get back to pre-1996 numbers,
    0:08:15 which is a pretty daunting thought.
    0:08:16 – Those numbers that Lloyd just cited
    0:08:21 that overdose death rates in the South
    0:08:23 were up 40 or 50% during COVID, I was skeptical.
    0:08:27 So I went and looked up the numbers.
    0:08:29 Turns out he was actually understating the COVID spike.
    0:08:33 Overdose deaths in Alabama, Louisiana and Tennessee
    0:08:36 were up more like 100% from 2018 to 2021,
    0:08:41 a doubling during COVID.
    0:08:43 So this gets me to wanting to ask you about fentanyl.
    0:08:49 When you were addicted, it was a different scenario really.
    0:08:54 Can you talk about the substances now
    0:08:57 and how that’s changed the game?
    0:08:59 – It’s so weird you ask me this
    0:09:00 ’cause I’ve actually struggled a little bit
    0:09:02 over the past couple of weeks
    0:09:03 because my sobriety date’s coming up July 8th
    0:09:06 and between May and July are usually fairly tough times for me
    0:09:09 because I go back 20 years and remember where I was.
    0:09:12 And the thing I realized was that when I was using back
    0:09:14 in early 2000s, fentanyl was not a thing.
    0:09:17 I mean, it was a drug and it was in the hospital
    0:09:19 and they were using it in surgeries
    0:09:20 and for cancer patients with patches and sprays,
    0:09:23 but it wasn’t illicit powder fentanyl
    0:09:25 that’s in absolutely everything now.
    0:09:27 And it dawned on me that it’s very likely
    0:09:30 towards the end of my using when I had to go to the street
    0:09:32 to get my supply that I would have run across fentanyl.
    0:09:34 So the landscape is night and day compared to 2004.
    0:09:38 – It sounds like what you’re saying is
    0:09:41 that if you’d been born 20 years later
    0:09:42 and lived the same life, you’d have been dead by now.
    0:09:44 – I’d have died, yeah, and that was the struggle
    0:09:46 because I recently become a grandparent.
    0:09:49 I can’t help myself, but to go there sometimes
    0:09:51 because 20 years later, you’re exactly right.
    0:09:53 There is a very high likelihood I would have died.
    0:09:56 – I have a really naive question
    0:09:58 because fentanyl is so deadly
    0:10:00 and because fentanyl is now so common
    0:10:03 in the illicit drug supply,
    0:10:05 why is that not enough to diminish demand?
    0:10:09 – Yeah, that’s always a good one.
    0:10:11 And to understand that,
    0:10:12 you’ve got to understand a little bit
    0:10:13 about the brain changes that happen in substance use.
    0:10:16 Essentially what happens is you lose access
    0:10:18 to the frontal lobe of your brain.
    0:10:19 And the frontal lobe of your brain is only important
    0:10:21 if you care anything about insight, judgment, and empathy.
    0:10:24 – Okay, and so if you’ve got somebody
    0:10:26 that’s solely driven by their pleasure center
    0:10:28 with no override from that, you know,
    0:10:30 insight, judgment, and empathy standpoint,
    0:10:32 I think you can pretty clearly see
    0:10:33 how come fentanyl doesn’t matter.
    0:10:35 Today we’re like, well, we’re not gonna use that,
    0:10:36 it’ll kill us.
    0:10:37 But we have fully functioning frontal lobes
    0:10:39 and people who are using don’t.
    0:10:41 – How much is it that versus or in addition to the fact
    0:10:45 that it’s just a great wild card in the drug supply?
    0:10:49 In other words, even if you do know about fentanyl,
    0:10:52 even if you are aware of its danger,
    0:10:54 even if you’re willing to take a chance once in a while,
    0:10:58 no one really knows how much of it is in the supplier,
    0:11:01 whether it might be in a given batch.
    0:11:04 So is that a bigger problem?
    0:11:06 Or do you think the bigger problem is just the fact
    0:11:08 that the high is too appealing
    0:11:09 and that the logic chain doesn’t even happen?
    0:11:12 – Oh, I think both of those things in combination
    0:11:14 are the problem.
    0:11:16 I mean, when I was using, I wanted the next thing
    0:11:18 that would get me where I needed to be.
    0:11:20 And if there was something that would get me there quicker
    0:11:21 or more intensely, I mean, that was the goal.
    0:11:24 Now you couple that with loss of that executive function
    0:11:28 coming from your frontal lobe of your brain
    0:11:30 and you can see, you know, how people get in trouble.
    0:11:33 – This trouble became so severe, so widespread
    0:11:36 that states and cities across the country
    0:11:39 sued the manufacturers of the legal opioids
    0:11:42 that started the crisis,
    0:11:43 along with the distributors and consultants
    0:11:45 who helped promote the drugs.
    0:11:47 – A number of states have now agreed
    0:11:49 to a $26 billion settlement
    0:11:52 with three large drug distributors
    0:11:54 and Johnson & Johnson
    0:11:56 for their roles in the opioids epidemic.
    0:11:59 CVS & Walgreens paying out $10 billion
    0:12:02 to settle lawsuits over the opioid crisis.
    0:12:05 – McKinsey & Company is gonna pay nearly $600 million
    0:12:09 for consulting businesses
    0:12:10 on how to sell more prescription opioid painkillers.
    0:12:14 – Although, as I mentioned earlier,
    0:12:16 the big one is still unresolved.
    0:12:19 – Today, the Supreme Court will review
    0:12:21 a $6 billion bankruptcy settlement
    0:12:24 between Purdue Pharma, the maker of OxyContin
    0:12:26 and the victims and communities
    0:12:28 ravaged by the opioid crisis.
    0:12:30 – Coming up after the break,
    0:12:34 how will these billions be used
    0:12:36 and what is it going to accomplish?
    0:12:39 I’m Stephen Dubner.
    0:12:40 This is Freakonomics Radio.
    0:12:41 We will be right back.
    0:12:42 (upbeat music)
    0:12:45 – There have been a lot of bad actors
    0:12:54 in the opioid crisis.
    0:12:56 The most widely vilified is Purdue Pharma,
    0:12:59 the private drug maker largely owned by the Sackler family,
    0:13:02 which made and sold the pain medication OxyContin
    0:13:05 under the false premise that it was less addictive
    0:13:07 than other opioids.
    0:13:09 But other companies have also been implicated.
    0:13:11 Manufacturers like Johnson and Johnson,
    0:13:14 Allergan and Teva, as well as distributors, pharmacies,
    0:13:18 pharmacy benefit plans, and the consulting firm McKinsey,
    0:13:22 which helped Purdue sell more drugs.
    0:13:26 All this has prompted thousands of lawsuits,
    0:13:28 some of them ongoing, but many already settled.
    0:13:32 These settlements will direct around $55 billion
    0:13:35 to the states to be distributed over the next 18 years.
    0:13:39 The Sackler family’s bankruptcy settlement
    0:13:41 could add another $6 billion to the settlement pool.
    0:13:45 Most of the settlements require the states
    0:13:48 to spend 85% of the money
    0:13:50 to directly address the opioid crisis.
    0:13:53 – This money has to go for certain things.
    0:13:55 You can’t just use it to balance your budget
    0:13:57 in your state or build roads and highways.
    0:13:59 – That again is Stephen Lloyd,
    0:14:01 the Tennessee physician who chairs
    0:14:03 his state’s opioid abatement council.
    0:14:06 – And so we’ve got an actual chance
    0:14:07 at this one actually making a difference
    0:14:09 for what it was intended to.
    0:14:10 – Can you talk about the process in Tennessee?
    0:14:13 How much is the money flowing so far
    0:14:15 and where it’s being applied?
    0:14:17 – Oh, it’s flowing, thank goodness, Stephen.
    0:14:19 I’m really proud of that.
    0:14:20 So Tennessee took 15% of their money
    0:14:23 from the funded minister or it goes to our general assembly.
    0:14:25 The politicians can spend it on what they want to.
    0:14:27 – Okay, so 15% is essentially slush fund.
    0:14:30 That’s not directly for opioids.
    0:14:32 – Yeah, you said that, not me.
    0:14:33 – Okay, fair enough.
    0:14:34 And then another 15% went to Tennessee as 95 counties.
    0:14:37 So another 15% went directly to those counties
    0:14:40 based on a formula that was agreed upon,
    0:14:42 population and problem.
    0:14:44 So they can actually use that for anything they want.
    0:14:46 So that’s 30% of the money.
    0:14:48 – But that second 15%, the share was derived
    0:14:51 from the amount of opioid trouble in that county though
    0:14:54 or no?
    0:14:55 – That’s exactly right.
    0:14:56 – But even so it’s non-directed funds.
    0:14:58 I can use it however I want.
    0:14:59 – You can hire a dog catcher if you want.
    0:15:01 – Got it.
    0:15:02 – And then the remaining 70%,
    0:15:03 the general assembly and our governor in Tennessee
    0:15:05 set up an independent council that has decision-making
    0:15:08 authority made up of 15 people appointed by our governor,
    0:15:10 our speaker of the house and our lieutenant governor.
    0:15:13 And they will decide how that 70% is spent.
    0:15:16 Now, 35% of that 70% goes back to the counties again
    0:15:20 based on that same formula from last time.
    0:15:22 Only this time it has to go from something
    0:15:25 called a remediation list.
    0:15:27 And a remediation list even is basically
    0:15:28 an abatement plan and we will hold them accountable.
    0:15:31 So Tennessee has had two distributions to that one already,
    0:15:34 both of them in excess of $30 million
    0:15:37 that went to those individual counties.
    0:15:39 Now that’s 35% of the 70, the remaining 65% of the 70
    0:15:44 was made available through a competitive grant process,
    0:15:47 which we just finished up the first round.
    0:15:50 – Give me a list of some things where that money is going.
    0:15:53 – Well, there’s four big buckets out there,
    0:15:54 prevention, education, treatment
    0:15:56 and something called harm reduction.
    0:15:58 So how do you break that money up
    0:16:00 in each of those individual buckets
    0:16:01 and those strategies to get to the goal that you want,
    0:16:03 which is actually shrink the number of people who use drugs.
    0:16:06 And I think that is the challenge
    0:16:07 and that is the ball that I see being dropped right now.
    0:16:10 You know, they say, well, how did you decide
    0:16:12 how much went in each of the four buckets in Tennessee?
    0:16:14 And I said, well, we use something called a swag method,
    0:16:16 scientific wild ass guess.
    0:16:18 – Lloyd would like to replace that guesswork
    0:16:22 with something more reliable.
    0:16:24 He is a member of a consortium called the Helios Alliance,
    0:16:27 which uses data science to try to learn
    0:16:29 which interventions are most effective
    0:16:31 and most cost effective.
    0:16:33 – You start looking at this money as it comes in.
    0:16:36 How do you allocate it to the individual strategies
    0:16:39 to get to a result that you’re trying to look for?
    0:16:42 Because if you just stick it out there, Stephen,
    0:16:44 and you measure it on the back end,
    0:16:45 how do you know if you’re even successful?
    0:16:47 – Based on what he’s learned so far,
    0:16:49 Lloyd says that of the four buckets,
    0:16:51 prevention, education, treatment and harm reduction,
    0:16:54 prevention offers the best return on investment.
    0:16:58 For every $1 that you invest in prevention with opioids,
    0:17:01 it’s an $11 downstream savings.
    0:17:03 Nothing’s even close to that.
    0:17:04 Treatments like one to four.
    0:17:06 – What about education?
    0:17:07 – Education, I would put as part of treatment.
    0:17:10 Education is gonna break down the barriers
    0:17:12 to people getting into treatment.
    0:17:14 – And what about harm reduction?
    0:17:15 – Harm reduction is simply keeping people alive.
    0:17:18 And I’m not sure what the return on investment dollar is,
    0:17:20 because right now, if Stephen Dubner overdoses,
    0:17:23 and we take you to the hospital here at Vanderbilt,
    0:17:25 you’re gonna be in there until they get you stable,
    0:17:27 and then you’re gonna hit the door.
    0:17:28 And there’s a good chance that you’re gonna overdose again
    0:17:31 the same afternoon and be right back in there.
    0:17:33 That happens all the time.
    0:17:35 So you’re spending a lot of harm reduction dollars,
    0:17:37 but a lot of times you’re spending it on the same people,
    0:17:39 just rotating in and out of emergency departments
    0:17:41 after the overdose.
    0:17:42 And that’s where we need to look at this system of care
    0:17:45 that your patient steps into.
    0:17:47 So some of the ideas, let me give you a good one.
    0:17:49 University of Tennessee Knoxville
    0:17:51 has an emergency department program
    0:17:52 where if you come in and you’ve overdosed,
    0:17:54 as soon as they get you stable, they’ll call a peer.
    0:17:56 Somebody who’s had this problem themselves,
    0:17:58 they’ll come down and talk to you
    0:17:59 and link you up to treatment right out
    0:18:01 of the emergency department.
    0:18:03 Those are the kind of things that I’m talking about.
    0:18:06 One of the things I see that dismays me
    0:18:08 is that a lot of people in this space
    0:18:10 are only interested in their part of it.
    0:18:12 I’m part of the treatment world myself.
    0:18:14 The reality is, when it comes to addiction,
    0:18:16 I’m a prevention guy,
    0:18:18 because I think it’s the only way
    0:18:19 that we move the needle going forward.
    0:18:21 – But what if I hear you give this pitch
    0:18:23 about these four buckets,
    0:18:24 and then I hear that the return on investment
    0:18:25 of prevention is $1 spent,
    0:18:27 you get $11 on return, and that easily beats all the rest.
    0:18:31 I say to you, oh, that’s fantastic.
    0:18:33 Let’s not worry about the other stuff.
    0:18:35 Let’s put it all in prevention.
    0:18:36 What would you say to that?
    0:18:38 – Well, I would think I was talking
    0:18:39 to somebody other than Stephen Dubner, first of all,
    0:18:41 because now you’re talking about letting people die.
    0:18:44 And I hope I never get to that point in my career,
    0:18:46 because that argument has been made.
    0:18:48 And here’s the problem with letting people die.
    0:18:50 They leave people behind, and a lot of times they’re kids.
    0:18:52 And if you look at the drivers of addiction
    0:18:54 as being genetics, trauma, and opportunity,
    0:18:57 you’re really not going to be able to kill your way
    0:18:58 out of this because of what’s left behind.
    0:19:00 So I have made the argument forever
    0:19:03 that the first step in prevention
    0:19:04 is treatment of mom and dad.
    0:19:06 And I think I can make that argument stick.
    0:19:08 Almost all of medicine is harm reduction.
    0:19:11 We don’t cure diabetes, right?
    0:19:12 We treat it to prevent the sequela, you know,
    0:19:14 heart attacks and strokes,
    0:19:16 but it’s hard to get people to see that
    0:19:17 when it comes to substance use disorder.
    0:19:19 In 2004, if somebody had said,
    0:19:22 “Steve, you have this addiction to oxycontin,”
    0:19:24 so what we’re going to do,
    0:19:25 we’re just going to give you oxycontin,
    0:19:26 all you want until you’ve had enough, okay?
    0:19:29 I would have died.
    0:19:31 So did we need to keep me alive?
    0:19:33 I hope, yes, we did need to keep me alive,
    0:19:35 but we also needed a path for me to get into recovery
    0:19:37 so I could raise my family
    0:19:39 and make sure I’m not creating
    0:19:40 the next generation right behind me.
    0:19:42 – When you talk about diabetes, it strikes me,
    0:19:44 that could be a pretty apt comparison
    0:19:46 in that a lot of cases of diabetes
    0:19:49 are brought about by personal choices
    0:19:51 and personal behavior, right?
    0:19:52 Diet, nutrition, exercise or the lack thereof,
    0:19:55 would you agree with that or not quite?
    0:19:57 – Absolutely.
    0:19:57 I mean, now type one’s different, right?
    0:19:59 – Type one’s different, yeah, let’s cross that off.
    0:20:01 – But far and away that, you know,
    0:20:02 most common cause of diabetes is type two
    0:20:04 and it’s behavioral.
    0:20:06 Most of type two diabetes is because of, you know,
    0:20:08 eating chocolate, cake and drinking Mountain Dew Code Red.
    0:20:10 And we have no issues
    0:20:13 with intervening with medication and diabetes.
    0:20:15 What’s the first line treatment for diabetes?
    0:20:16 Diet and exercise, all right?
    0:20:18 And I challenge anybody out there
    0:20:20 to show me five patients in their practice
    0:20:22 that adhered to their diet and exercise
    0:20:23 and control their blood sugar.
    0:20:25 Yet, if you see somebody out there
    0:20:27 who’s got their A1C less than 6.5
    0:20:29 and they’re on three different medications
    0:20:30 in order to do so, nobody’s asking them
    0:20:32 when they’re gonna come off.
    0:20:33 They’re just glad that they’re not at such high risk
    0:20:36 to have these bad things happen.
    0:20:38 Again, addiction is treated differently
    0:20:40 than every other disease I can think of in our country.
    0:20:43 (upbeat music)
    0:20:46 – So Stephen, you have been sketching out
    0:20:48 a lot of the problems here.
    0:20:49 Do you have any good news?
    0:20:52 You know, if you’re listening to this
    0:20:53 and you wanna know what’s going on
    0:20:54 with the money in your county,
    0:20:56 then you need to get involved
    0:20:57 and you need to make your voice heard,
    0:20:58 particularly if you have lived experience.
    0:21:00 And so I think there is good news, Stephen.
    0:21:02 And I think there’s people out there
    0:21:03 that are starting to listen
    0:21:05 to some of the things that we’re talking about.
    0:21:07 When that happens,
    0:21:07 when it happens on a big enough scale,
    0:21:09 then I think we have a chance
    0:21:10 at tying some systems together
    0:21:12 that have a chance to become a system of care
    0:21:14 over the next two to three decades.
    0:21:16 – How do you suggest people get involved?
    0:21:18 – Starts at the local level.
    0:21:19 A lot of this money is going directly to the counties
    0:21:22 as I described to you.
    0:21:23 I guarantee you that the mayor of your county
    0:21:25 or the city commission or county commission where you live,
    0:21:28 they know they got a big check.
    0:21:29 Okay, came as a wire transfer.
    0:21:31 Ask them what they’re doing with it.
    0:21:32 Ask them what the process is and how to spend it.
    0:21:34 (upbeat music)
    0:21:37 – There’s also a way to track the $55 billion
    0:21:40 in settlement money,
    0:21:41 or at least try to track it.
    0:21:43 That is thanks to this person.
    0:21:45 – My name is Christine Minhee.
    0:21:47 I am the founder of OpioidSettlementTracker.com.
    0:21:50 Minhee received her law degree
    0:21:52 from the University of Washington in 2019.
    0:21:55 – I started the project after I got obsessed
    0:21:58 with the big tobacco litigation as a law student,
    0:22:02 quickly realized that we were hurtling
    0:22:04 into the same dismal landscape of poor spending
    0:22:08 with opioid settlements without any guardrails.
    0:22:12 – In 1998, the four biggest tobacco companies in the US
    0:22:16 agreed to what was called
    0:22:17 the Tobacco Master Settlement Agreement.
    0:22:20 This meant paying out some $250 billion to the states
    0:22:24 to help cover the costs incurred
    0:22:26 by the consumption of their product.
    0:22:28 A product that like Oxycontin was legal,
    0:22:32 but carried significant risks
    0:22:34 that the manufacturers lied about.
    0:22:37 That $250 billion has gone into state budgets
    0:22:40 where it was spent on healthcare costs for smokers,
    0:22:43 on anti-smoking campaigns,
    0:22:46 but sometimes just to make up budget shortfalls.
    0:22:49 That’s what Christine Minhee doesn’t want to see repeated
    0:22:52 with the opioid settlement money.
    0:22:54 – That nightmare of big tobacco spend
    0:22:57 certainly cast a pall over the opioid settlement landscape.
    0:23:01 So I didn’t trust that there was going to be another entity
    0:23:05 that would watch how these settlements would be spent.
    0:23:07 And I decided to just create a beta concept
    0:23:11 that I imagined some agency would take over after.
    0:23:15 But lo and behold, a number of years later,
    0:23:17 I’m continuing to do this.
    0:23:18 – As we heard earlier from Steven Lloyd,
    0:23:20 there is a formula for how the opioid settlement money
    0:23:23 is to be distributed.
    0:23:25 – The way that they’re divvied up across the states
    0:23:27 is determined by a single table
    0:23:29 and the settlement agreements actually.
    0:23:31 And this global allocation percentage table
    0:23:35 is derived by using a formula that uses three factors,
    0:23:40 how many pills were shipped to a particular jurisdiction,
    0:23:43 how many folks have died
    0:23:45 from an opioid use disorder related overdose,
    0:23:48 and how many folks are currently suffering from OUD
    0:23:52 within a particular jurisdiction.
    0:23:54 – But once you get past that formula, Minhee found,
    0:23:58 there wasn’t much in the way of accountability
    0:24:00 of how the money would be spent.
    0:24:02 – The reporting requirements attached
    0:24:04 to the opioid settlement agreements
    0:24:06 are virtually non-existent.
    0:24:08 – With opioidsettlementtracker.com,
    0:24:10 she is hoping to change that.
    0:24:12 So far, 20 states do voluntarily report
    0:24:16 all their settlement spending.
    0:24:18 Others, including Tennessee,
    0:24:20 are reporting some of their spending,
    0:24:22 but some don’t make any information public.
    0:24:25 – Texas has decided not to report its specific expenditures.
    0:24:29 We have no official state promulgated proof of spend
    0:24:34 for Texas’s $2.8 billion.
    0:24:37 And that is a travesty for all of the million
    0:24:41 moral reasons that I can input.
    0:24:43 But it’s also a travesty from a data perspective
    0:24:47 because we’re waltzing into this landscape
    0:24:49 where we’re just gonna have no sense
    0:24:51 of how these monies were actually spent
    0:24:53 or whether or not they’re moving the needle on public health.
    0:24:56 – You keep distributing money to the same things
    0:25:01 that you’ve been distributing it for the last 20 years
    0:25:03 that have led you here.
    0:25:04 – Stephen Lloyd again.
    0:25:05 – The only way to break that is to do something different.
    0:25:08 I mean, the definition of insanity, right?
    0:25:10 Doing the same thing over and over,
    0:25:11 expecting a different result.
    0:25:12 – When you talk about the money that’s been spent
    0:25:14 and hasn’t achieved the goal,
    0:25:16 how is that money historically or traditionally spent?
    0:25:19 – It comes in from the federal government,
    0:25:21 usually in block grant through its State Department
    0:25:23 of Mental Health or Substance Abuse
    0:25:24 or whatever their equivalent is.
    0:25:25 And then they dole it out to their organizations
    0:25:27 who are carrying out programs in their state.
    0:25:30 And my issue with that,
    0:25:31 and I’m not knocking the work that’s being done,
    0:25:34 there’s a lot of people doing really, really good work.
    0:25:37 I wanna see meaningful outcomes,
    0:25:38 not how many people we were able
    0:25:40 to do a physical exam on in 24 hours.
    0:25:43 Is that important?
    0:25:43 Yes, do I care?
    0:25:45 No, I don’t care.
    0:25:46 What I care about is how many of those people
    0:25:48 went through the program and when they got out,
    0:25:51 were able to sustain their recovery.
    0:25:53 How many of them got back into their jobs?
    0:25:55 How many of them got a new job?
    0:25:56 How many of them were able to provide for their family?
    0:25:58 I want meaningful data.
    0:26:01 Just like we would for heart attack.
    0:26:02 If you put a stint in somebody,
    0:26:04 “Oh, we gotta stand in there and the flow was great.”
    0:26:06 And two days later, they died of a heart attack.
    0:26:08 Okay, if you just measured the flow and said that’s a success,
    0:26:11 I would tell you that was a failure.
    0:26:12 So it sounds like there is a greater than zero chance
    0:26:16 that if we were talking 15 or 18 years from now,
    0:26:20 that someone, maybe you, would have the same complaints
    0:26:23 about how the money has been spent
    0:26:25 that you’ve had about how the money has been spent,
    0:26:28 for instance, in West Virginia over the past 20 years.
    0:26:30 What do you think are the odds of that?
    0:26:32 It’s my nightmare.
    0:26:33 I mean, not very many things keep me up at night anymore.
    0:26:37 This one keeps me up at night because I’m scared
    0:26:39 that we’re going to, we’re going to blow it.
    0:26:41 So when I speak with you, Stephen,
    0:26:43 I get the sense that addiction is sort of a language
    0:26:47 that if you don’t speak it, you don’t speak it.
    0:26:50 And that’s a problem because you need people
    0:26:53 who don’t speak the language to be involved in,
    0:26:57 let’s say, the treatment or the teaching of that language.
    0:27:01 If you have policymakers that don’t speak the language
    0:27:03 and don’t understand what I just said,
    0:27:05 think of some of the things
    0:27:06 that you can come out of this with.
    0:27:08 I mean, policy that’s harmful.
    0:27:09 – So what kind of policies won’t be harmful?
    0:27:15 That’s after the break, I’m Stephen Dubner,
    0:27:17 and this is Freakonomics Radio.
    0:27:19 The United States has the highest rate
    0:27:31 of drug overdose deaths in the world.
    0:27:33 And in recent years, the problem has continued to worsen.
    0:27:37 As we’ve been discussing over these past two episodes,
    0:27:40 the opioid epidemic has a variety of causes,
    0:27:44 but what about the consequences?
    0:27:46 The death and suffering and broken families,
    0:27:50 those are all front and center, but there are others.
    0:27:54 Because this crisis originated
    0:27:56 with the legal medical distribution
    0:27:59 of an addictive substance,
    0:28:01 the medical community especially has fought back hard.
    0:28:05 Everyone now admits that opioids
    0:28:07 were wildly overprescribed for a long time.
    0:28:10 And since 2010, the rate of opioid prescription
    0:28:15 has fallen by at least 50%.
    0:28:17 The system has made it significantly harder
    0:28:20 to get certain drugs.
    0:28:22 But this too has had a cost.
    0:28:25 A lot of people who need these drugs for pain management
    0:28:29 aren’t able to get them.
    0:28:31 Most people who use prescription opioids don’t become addicted,
    0:28:35 but because some do, and because this addiction
    0:28:39 to illegal product created a massive market
    0:28:42 for illegal versions of that product,
    0:28:45 the legitimate prescription of some opioids
    0:28:47 by legitimate physicians has been constrained.
    0:28:51 And people have suffered because of that too.
    0:28:54 In 2022, the CDC issued new prescription guidelines
    0:28:58 that continue to emphasize opioid alternatives,
    0:29:01 but also call for flexibility
    0:29:04 to allow their use when needed.
    0:29:06 Perhaps all these wrinkles shouldn’t surprise us.
    0:29:10 Every epidemic has its own history,
    0:29:13 its own trajectory and rebound effects,
    0:29:16 its own way of making trouble.
    0:29:18 I asked Stephen Lloyd if he could point to an epidemic
    0:29:22 from history, whether ancient or modern,
    0:29:25 that seems to parallel the opioid epidemic.
    0:29:28 – Stephen, I think the opioid epidemic
    0:29:30 is this generation’s HIV and AIDS.
    0:29:33 There’s so many parallels.
    0:29:34 I’m getting ready to be 57.
    0:29:36 And so I lived through that in the early ’80s.
    0:29:38 First of all, it’s the descents.
    0:29:40 If somebody had HIV disease, they were gonna die
    0:29:41 and we knew it.
    0:29:43 The really big thing was stigma.
    0:29:44 Don’t swim in the pool with these kids
    0:29:46 and really the biggest hurdle
    0:29:47 because we actually had AZT pretty early on
    0:29:49 in the AIDS epidemic,
    0:29:50 but there were barriers to getting the treatment.
    0:29:53 And then you had these groups.
    0:29:54 The one I remember is ACT UP.
    0:29:56 Got out and made a lot of noise
    0:29:57 and started fast-tracking medications through the FDA.
    0:30:00 And then you had several notable cases
    0:30:02 that started to change the face of it.
    0:30:04 Ryan White, Arthur Ashe, Urban Magic Johnson.
    0:30:07 You look at HIV disease and AIDS.
    0:30:09 And now when’s the last time you saw an article on it?
    0:30:11 My son just turned 30 years old
    0:30:13 and he doesn’t remember HIV and AIDS being a descents.
    0:30:17 And if you parallel that to what we’re seeing
    0:30:19 with the opioid epidemic, there are so many similarities.
    0:30:21 What’s the biggest thing that prevents people
    0:30:23 from getting treatment right now, stigma?
    0:30:25 But it’s been a while now.
    0:30:27 Why do you think the stigma has not receded?
    0:30:29 People just look at addiction differently, Stephen.
    0:30:32 Last night, I was in a rural town here
    0:30:34 just east of Nashville and the decision makers
    0:30:37 in that town understood almost nothing about addiction.
    0:30:40 You’re still under the impression that,
    0:30:42 well, this little town doesn’t need
    0:30:44 what you wanna bring here because we’re not Memphis
    0:30:46 or we’re not Nashville or New York City.
    0:30:48 And that’s somebody who doesn’t understand
    0:30:50 the demographics of this.
    0:30:52 I mean, this started out as a rural problem
    0:30:53 and it still is a rural problem.
    0:30:55 And so you’re off base there,
    0:30:57 but then you wanna send somebody away for 10, 20, 30 days
    0:31:00 and have them come back fixed.
    0:31:02 And that’s not how this works.
    0:31:03 It’s a lifelong process.
    0:31:04 And so if those are the people driving your policy,
    0:31:07 then you can start to imagine some of the things
    0:31:09 you come out of this with and you actually have people
    0:31:11 that will die never knowing that there’s life-saving
    0:31:13 medication out there to help them.
    0:31:15 Sometimes I feel like I’m working
    0:31:17 in the days of the Salem witch trials
    0:31:19 because we know so much about addiction.
    0:31:21 Now, we know things that are effective.
    0:31:23 We know medications that are effective,
    0:31:25 but when you start getting in rural territories,
    0:31:27 you’re right back to those times
    0:31:30 where you’re looking at this as a moral failure
    0:31:31 and the only treatment is a higher power or a deity.
    0:31:35 I ran into it last night in front of that zoning commission
    0:31:38 and I couldn’t overcome it.
    0:31:40 I lost.
    0:31:41 – You said you couldn’t get them to buy
    0:31:43 what you were selling.
    0:31:43 What were you selling in that case?
    0:31:45 – I was trying to show them the fact that addiction
    0:31:48 is like any other medical disease
    0:31:50 that deserves the same opportunities for treatment.
    0:31:53 That’s it.
    0:31:54 – Were you proposing a facility?
    0:31:55 Were you proposing?
    0:31:56 – Facilities that did everything.
    0:31:58 Behavioral health counseling, mental health issues,
    0:32:00 getting a family of origin issues,
    0:32:02 all the stuff that goes around addiction
    0:32:04 like housing, stable food source, income,
    0:32:06 and then for the population that needs it, medication.
    0:32:09 And when you start talking medication,
    0:32:10 particularly in rural areas,
    0:32:12 the thing that pops out right off the bat,
    0:32:13 oh, you’re just trading one drug for another.
    0:32:15 That’s it.
    0:32:16 They seem to not understand that we’re going to save lives.
    0:32:20 And if I’m completely honest,
    0:32:22 the biggest drawback that I have in the States I work in
    0:32:25 is the church.
    0:32:26 – Because the church has a kind of bright line
    0:32:28 over use, don’t use?
    0:32:30 – Absolutely.
    0:32:31 If you pray enough and you walk enough little old ladies
    0:32:33 across the street, then you won’t have this issue.
    0:32:36 One of the arguments last night is,
    0:32:38 and these are their words, not mine,
    0:32:39 ’cause I don’t use these words,
    0:32:40 but we’re gonna bring drug addicts in here.
    0:32:43 Well, I’ve been working in that particular town
    0:32:45 for a good while, and I can promise you,
    0:32:47 they’re already there.
    0:32:48 – This is a paraphrase of you describing
    0:32:50 how the Helios model works.
    0:32:53 The idea is to use statistical modeling
    0:32:55 and artificial intelligence to simulate the opioid crisis,
    0:32:58 predict which programs will save the most lives
    0:33:01 and help local officials to decide
    0:33:03 the best use of settlement dollars.
    0:33:05 It sounds good, but I could also see someone hearing that
    0:33:08 and saying, oh, that just sounds like consultants
    0:33:12 getting their piece of this.
    0:33:14 And it doesn’t sound close enough to the ground to me.
    0:33:18 It doesn’t sound like it’s going to physically address
    0:33:22 the actuality of this epidemic.
    0:33:24 What would you say to that suspicion?
    0:33:26 – First of all, I’ve never been accused
    0:33:28 of being a consultant,
    0:33:29 and I’m certainly not McKenzie material.
    0:33:32 It’s what I see, and I saw it when we modeled the cases,
    0:33:35 ’cause my job in the cases was to show causation, right?
    0:33:38 To draw a direct line from the mispromotion
    0:33:40 of the drug oxycontin to today’s heroin
    0:33:41 and fentanyl epidemic, that’s my job.
    0:33:44 And when I saw what modeling did to reinforce the story
    0:33:48 that I told that I physically saw and experienced
    0:33:51 as a patient and a provider, I was overwhelmed by it.
    0:33:55 And so it may sound like consultants speak
    0:33:57 and maybe somebody cleaned my words up.
    0:33:59 I mean, you’ve talked to me long enough to know
    0:34:01 that I probably can’t talk that well.
    0:34:02 – Yeah, I was going to say those words on the page
    0:34:04 don’t really sound like you sound now that I’m talking to you.
    0:34:07 – They don’t, so somebody cleaned them up,
    0:34:09 but the idea is the same.
    0:34:10 And the idea is that we have to know
    0:34:12 what our current assets are, what our current system is.
    0:34:14 We have to be able to model that
    0:34:16 so that we can make the best decisions
    0:34:17 on how to allocate the money.
    0:34:19 And that’s Steve Lloyd’s words.
    0:34:20 – Stephen Lloyd plainly believes
    0:34:24 that the stigma associated with addiction
    0:34:26 is a major reason this epidemic has continued to rage on.
    0:34:31 In part one of this series,
    0:34:32 we featured the Stanford Drug Researcher
    0:34:34 and Policy Advisor, Keith Humphries.
    0:34:37 He believes that stigma is important,
    0:34:39 that if you remove all the barriers from drug use,
    0:34:43 not just legal barriers, but social barriers,
    0:34:46 then you are inviting trouble.
    0:34:49 That said, Humphries and Lloyd do agree
    0:34:51 that the opioid crisis has gone on far too long,
    0:34:55 that there are ways to stop it,
    0:34:57 and that the settlement money coming in now
    0:34:59 from the opioid producers is a key to all of that.
    0:35:03 We went back to Humphries for his take
    0:35:05 on how the money should be spent.
    0:35:08 – These settlements are massive.
    0:35:09 They are multi-billion dollar settlements.
    0:35:12 They are, however, paid out over very long periods.
    0:35:15 So I was talking to a governor about what impact it has.
    0:35:19 She said, it’s like an extra 6% of our budget
    0:35:22 for the next 25 years.
    0:35:24 So when you thought of it that way,
    0:35:25 it’s like, oh, that’s not really that much.
    0:35:26 I mean, you know, it’s at billions,
    0:35:27 but if it’s paid out over very long times, right?
    0:35:30 So, you know, the question will be
    0:35:33 since this is to abate the problem
    0:35:34 is how do municipalities and states
    0:35:38 use it as wisely as possible?
    0:35:40 And what I tell them is like,
    0:35:41 don’t spend any money on anything
    0:35:43 some other funding stream covers.
    0:35:46 Like building a clinic, that’s,
    0:35:48 where do you get money to build?
    0:35:49 Medicaid, Medicare will not pay to build a clinic.
    0:35:51 But if you build a clinic and if you have staff,
    0:35:53 then Medicaid and Medicare will pay your staff sorry forever.
    0:35:57 I’ve also been pitching,
    0:35:57 please do something for prevention
    0:35:59 because, you know, we have funding streams,
    0:36:02 private and public insurance,
    0:36:04 that pay for the care of people who are ill,
    0:36:05 but there really isn’t, you know,
    0:36:07 good funding streams for prevention
    0:36:09 for people who are not yet ill, mainly kids.
    0:36:13 – There is an organization at the University of Washington
    0:36:15 that Humphrey sees as a good model
    0:36:17 for setting up youth prevention systems.
    0:36:20 They’re called communities that care
    0:36:21 and they consult with various communities
    0:36:24 to in their language,
    0:36:25 promote the healthy development of young people.
    0:36:28 – Making investments in kids around the ages of 10, 11, 12
    0:36:32 has many good outcomes.
    0:36:34 A lot of people don’t think about prevention enough.
    0:36:36 They think about the current crisis,
    0:36:37 but you have to think long-term
    0:36:38 if you want to deal with epidemics.
    0:36:40 So I would use this money for things,
    0:36:42 nothing else can pay for.
    0:36:43 So that would be prevention with kids
    0:36:45 ’cause there is no funding stream for that.
    0:36:47 I would certainly do infrastructure.
    0:36:50 There’s places where there are no methadone clinics.
    0:36:52 So you need a building.
    0:36:53 You can’t pay for a building with health insurance,
    0:36:55 but you could pay for it with this.
    0:36:57 Could also potentially do some things with technology.
    0:36:59 So you can have investments for telehealth.
    0:37:01 So people don’t have to come in as often
    0:37:04 that often there’s a way to retain them and care better.
    0:37:06 That’s something we could do.
    0:37:08 Let’s think, what hangs over all this
    0:37:09 is the shadow of the tobacco settlement.
    0:37:11 Very little of it was spent on tobacco.
    0:37:14 You know, pottles and that kind of thing.
    0:37:15 So there’s far more monitoring
    0:37:16 and far more transparency of where the money is going.
    0:37:20 However, these decisions, remember,
    0:37:21 these are city, states, counties, the Fed.
    0:37:23 The levels of decision-making are varied.
    0:37:27 And there will be places where they say,
    0:37:28 well, what we need are new police cruisers.
    0:37:31 So there’s gonna be problems for sure of misallocation.
    0:37:34 I think that’s just inevitable.
    0:37:36 – You wrote in 2019,
    0:37:38 if no Sacklers end up behind bars,
    0:37:40 an entire class of people will continue to feel
    0:37:42 that writing a check is the worst thing
    0:37:44 that will happen to them no matter what they do.
    0:37:47 As far as I know, no Sacklers in jail,
    0:37:48 what’s your position now, a few years later?
    0:37:51 – I’m only more cynical
    0:37:52 ’cause not only did no Sacklers go to jail,
    0:37:54 but another company they own, Moondi Pharma,
    0:37:57 is now selling Oxycontin all over the world
    0:37:59 just like they sold it here.
    0:38:00 So they haven’t been punished
    0:38:02 and they’re continuing to profit.
    0:38:04 – Moondi Pharma, headquartered in England,
    0:38:08 is indeed owned by members of the Sackler family,
    0:38:11 although they may be required to dispose of it
    0:38:14 as part of Purdue Pharma’s bankruptcy settlement.
    0:38:17 So what happens next?
    0:38:20 Does the opioid crisis spread to other parts of the world?
    0:38:24 Does the US create a successful playbook
    0:38:28 to fight the crisis here?
    0:38:30 I hope these are the questions that people in power
    0:38:33 are asking themselves right now.
    0:38:36 I also hope that we don’t find ourselves back here
    0:38:39 in another five years making yet another episode
    0:38:42 about this epidemic.
    0:38:43 I’d like to thank Stephen Lloyd, Keith Humphries,
    0:38:47 Christine Minhee, and last week,
    0:38:49 David Cutler and Travis Donahoe for speaking with us.
    0:38:54 And most of all, I’d like to thank you,
    0:38:55 as always, for listening.
    0:38:57 Let us know what you’re thinking.
    0:38:59 Our email is radio@freakinomics.com.
    0:39:03 Coming up next time on the show.
    0:39:07 – So this is an amazing story.
    0:39:09 – Tom Whitwell is a bit like Superman,
    0:39:13 mild-mannered, toiling away at his work,
    0:39:15 mostly hidden from the world.
    0:39:17 But once a year, he emerges with a list,
    0:39:22 a list of the 52 things he’s learned that year.
    0:39:26 For instance.
    0:39:27 – Fondue was invented by the cheese industry.
    0:39:30 – Some of these things are true things
    0:39:31 that we didn’t know to be true.
    0:39:33 – The basic story was the NHS uses 10% of remaining pages.
    0:39:37 – And some are things we’ve been told are true
    0:39:40 that quite likely aren’t.
    0:39:42 The whole idea of blue zones, for instance.
    0:39:46 That’s next time on the show.
    0:39:48 Until then, take care of yourself.
    0:39:50 And if you can, someone else too.
    0:39:53 Freakinomics Radio is produced by Stitcher and Renbud Radio.
    0:39:56 You can find our entire archive on any podcast app also
    0:40:00 at freakinomics.com, where we publish transcripts
    0:40:03 and show notes.
    0:40:04 This episode was produced by Alina Cullman and Zak Lipinski.
    0:40:08 Our staff also includes Augusta Chapman,
    0:40:11 Dalvin Abouaji, Eleanor Osborne, Elsa Hernandez,
    0:40:14 Gabriel Roth, Greg Rippin, Jasmine Klinger,
    0:40:16 Jeremy Johnson, Julie Canfer, Lyric Bowditch,
    0:40:19 Morgan Levy, Neil Carruth, Rebecca Lee Douglas,
    0:40:22 Sara Lilly, and Teo Jacobs.
    0:40:24 Our theme song is “Mr. Fortune” by the Hitchhikers.
    0:40:27 Our composer is Luis Guerra.
    0:40:29 – Big hockey game tonight.
    0:40:34 For a kid to grow up in the South
    0:40:36 and realize that there’s a hockey team in Nashville,
    0:40:38 it’s kind of a weird thing.
    0:40:39 – The Freakinomics Radio Network.
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    0:40:52 you
    0:40:54 you

    Thanks to legal settlements with drug makers and distributors, states have plenty of money to boost prevention and treatment. Will it work? (Part two of a two-part series.)

     

    • SOURCES:
      • Keith Humphreys, professor of psychiatry and behavioral sciences at Stanford University.
      • Stephen Loyd, chief medical officer of Cedar Recovery and chair of the Tennessee Opioid Abatement Council.
      • Christine Minhee, founder of OpioidSettlementTracker.com.

     

     

  • 589. Why Has the Opioid Crisis Lasted So Long?

    AI transcript
    0:00:00 (dramatic music)
    0:00:02 – Several years back,
    0:00:05 we published a two-part series called The Opioid Tragedy.
    0:00:09 We interviewed physicians and economists,
    0:00:12 substance abuse counselors, and recovering addicts,
    0:00:15 and we all talked about how bad
    0:00:17 the opioid epidemic was back then.
    0:00:19 – About 70,000 individuals died from a drug overdose
    0:00:22 just in 2017.
    0:00:24 That’s more Americans than were ever killed
    0:00:28 by guns, car crashes, or HIV/AIDS in a single year.
    0:00:32 – We also discussed a variety of solutions,
    0:00:35 some of them straight up medical solutions.
    0:00:38 – Opiate use disorder is treatable.
    0:00:40 It’s not a death sentence,
    0:00:41 it’s a medical condition, and it’s treatable.
    0:00:44 – And we also talked about harm reduction.
    0:00:46 That’s the idea that when it is not practical
    0:00:48 to outright prohibit something that’s dangerous,
    0:00:51 it’s worth finding a compromise.
    0:00:53 In the case of a dangerous opioid like fentanyl,
    0:00:57 that might mean treating people
    0:00:58 with a less addictive opioid like buprenorphine.
    0:01:01 In a later episode, we discussed harm reduction
    0:01:04 with Rahul Gupta, director of national drug policy
    0:01:08 in the Biden administration.
    0:01:09 – This administration has been very clear
    0:01:12 for the first time in the history
    0:01:14 of the United States federal government.
    0:01:17 We have made harm reduction the central tenet
    0:01:20 of how we need to move forward.
    0:01:22 – Gupta told us about government-funded needle exchanges
    0:01:25 and the distribution of naloxone,
    0:01:28 a drug that can rapidly reverse an opioid overdose.
    0:01:32 There have been other developments
    0:01:33 in the fight against opioid overdose deaths,
    0:01:36 including an intensive law enforcement campaign
    0:01:39 to cut down on drug trafficking.
    0:01:41 Also, billions of dollars of settlement money
    0:01:44 has started to flow from the opioid manufacturers,
    0:01:47 distributors, and consultants
    0:01:49 who did such a good job of selling their products.
    0:01:52 So with all that money and all that law enforcement
    0:01:57 and with harm reduction and medical treatments,
    0:02:01 you might think we had the problem surrounded.
    0:02:04 You would certainly think that opioid deaths
    0:02:06 would be falling, but they’re not.
    0:02:09 – It’s horrible.
    0:02:10 It’s absolutely horrifying.
    0:02:12 – That is Keith Humphries.
    0:02:14 – I’m a professor of psychiatry
    0:02:16 and an addiction researcher at Stanford University.
    0:02:18 – Humphries has also worked on drug policy
    0:02:21 for the Bush and Obama administrations
    0:02:24 and for Joe Biden’s presidential campaign.
    0:02:26 He has watched in horror
    0:02:28 as annual opioid deaths continued to climb.
    0:02:32 Today on Freakinomics Radio,
    0:02:35 I wish we weren’t doing this,
    0:02:36 but we are starting another two-part series
    0:02:39 on the opioid epidemic
    0:02:41 to try to figure out why it keeps getting worse.
    0:02:45 Some of the answers are very simple.
    0:02:47 – Depression feels bad every day.
    0:02:50 Drug use doesn’t feel bad.
    0:02:51 Drug use feels incredible.
    0:02:53 – But there are other hidden factors
    0:02:55 that are driving the epidemic
    0:02:56 and we will explore those too.
    0:02:58 We will find out which of the proposed solutions
    0:03:01 have failed and why
    0:03:03 and we’ll ask what might work better.
    0:03:05 We’ll try to track where those billions
    0:03:07 of settlement dollars are going
    0:03:09 and we’ll ask some questions
    0:03:11 that may make you uncomfortable.
    0:03:13 For instance, in recent years,
    0:03:15 there has been a push to de-stigmatize drug use.
    0:03:19 – Is it time to maybe bring back the stigma?
    0:03:22 (dramatic music)
    0:03:25 (upbeat music)
    0:03:31 – This is Freakinomics Radio,
    0:03:40 the podcast that explores the hidden side of everything
    0:03:43 with your host, Stephen Dubner.
    0:03:45 (upbeat music)
    0:03:48 Most epidemics come out of nowhere,
    0:03:57 do their damage and fade away.
    0:04:00 Why is the opioid epidemic different?
    0:04:03 To answer that question,
    0:04:04 we need to add some context and some history.
    0:04:07 – Opioids are perhaps the most abused substance
    0:04:11 in the history of the world.
    0:04:13 – That is David Cutler.
    0:04:15 I’m a professor of economics at Harvard.
    0:04:17 – Cutler is one of the most prominent
    0:04:19 healthcare economists in the world.
    0:04:20 And like Keith Humphries,
    0:04:22 he has done his share of government service.
    0:04:25 Cutler was an economic advisor
    0:04:27 in the Clinton administration
    0:04:28 and a healthcare advisor
    0:04:29 on Barack Obama’s first presidential campaign.
    0:04:32 He has also consulted with state and city governments.
    0:04:35 – Anyone who’s interested
    0:04:36 in helping make healthcare work better
    0:04:39 is someone who I’m happy to talk to.
    0:04:41 – And what would you say if I said,
    0:04:42 well, I get that you’re an economist
    0:04:44 and that you may know a lot about certain things,
    0:04:47 but how does that most fruitfully intersect
    0:04:51 with healthcare policy making especially?
    0:04:54 – An enormous amount of healthcare policy
    0:04:56 has to do with economics.
    0:04:58 For example, what incentives can you give physicians
    0:05:01 so that they do things that you want to happen
    0:05:03 but not things you don’t want to happen?
    0:05:06 Or what incentives can you use for individuals
    0:05:08 to help them take the medications that they should take
    0:05:11 and not take medications that they shouldn’t take
    0:05:13 and not smoke and behave healthy and so on?
    0:05:16 We’re dealing with incentives.
    0:05:18 We’re dealing with how to design a system so that it works.
    0:05:22 Those are things that economics really knows a lot about.
    0:05:25 Not everything in healthcare is just economics,
    0:05:28 but it’s also the case that if you don’t bring
    0:05:30 an economics lens to issues,
    0:05:33 you often get many things wrong.
    0:05:35 – Cutler has recently focused his economic lens on opioids,
    0:05:39 which as he mentioned earlier,
    0:05:41 have been around for millennia.
    0:05:44 – People, of course, smoked opium forever.
    0:05:47 There were wars fought over the right
    0:05:49 to import opium to China.
    0:05:52 Some of what’s happened over time
    0:05:54 is we’ve gotten better at extracting the key ingredients.
    0:05:57 So heroin and morphine are both derivatives
    0:06:00 of the opium poppy and those are more potent.
    0:06:04 – The ancient Sumerians used to call this poppy the joy plant.
    0:06:08 Today, we are dealing not just with natural opiates,
    0:06:12 but with synthetic and semi-synthetic versions.
    0:06:16 The one you’re probably most familiar with is fentanyl,
    0:06:18 an incredibly powerful drug that was developed
    0:06:21 in the late 1950s as an anesthetic.
    0:06:23 It is still widely used in hospitals
    0:06:26 for anesthesia and pain management,
    0:06:29 but it’s the street version of fentanyl
    0:06:31 that’s causing most of the overdose deaths today.
    0:06:34 A fentanyl overdose kills
    0:06:36 by slowing down the respiratory system so much
    0:06:39 that there’s not enough oxygen reaching the brain.
    0:06:41 And opioids are extraordinarily addictive.
    0:06:45 Widespread addiction in the U.S.
    0:06:47 goes back to at least the Civil War
    0:06:49 when wounded soldiers were given opium and morphine,
    0:06:52 a derivative developed in the early 19th century
    0:06:54 and named after Morpheus, the Greek god of dreams.
    0:06:58 The current epidemic also has a medical history.
    0:07:03 It started in the 1990s
    0:07:04 when the American pharmaceutical firm Perdue Pharma
    0:07:08 began promoting a new opioid called Oxycontin.
    0:07:11 The big breakthrough was that Oxycontin
    0:07:13 wasn’t nearly as addictive as other opioids.
    0:07:17 At least that’s what Perdue claimed.
    0:07:20 But that claim turned out to be,
    0:07:23 what’s the word I’m looking for here?
    0:07:25 False.
    0:07:27 By the time this falsehood was widely known,
    0:07:30 Perdue was selling billions of dollars worth
    0:07:32 of Oxycontin a year and hoped to continue.
    0:07:36 For many people, the introduction of Oxycontin
    0:07:39 marks the outbreak of the modern epidemic.
    0:07:42 From the mid 1990s through roughly 2010,
    0:07:46 you see increasing supplies, just massive, massive supplies,
    0:07:50 like a five-time increase in opioid prescriptions,
    0:07:55 opioid use, a massive increase in deaths from opioids.
    0:07:59 And these are mostly legal substances
    0:08:02 used by people to whom it was prescribed.
    0:08:05 Much of it was used by people to whom it was prescribed,
    0:08:08 but some of it then gets passed on to friends and relatives.
    0:08:12 There becomes a black market for it.
    0:08:14 So people who are addicted will buy it from others.
    0:08:18 There are pill mills where they’ll,
    0:08:20 in principle, examine you, but not really.
    0:08:22 They’ll give you a prescription, you pay all in cash,
    0:08:25 you get the drugs.
    0:08:26 We talked quite a bit in our earlier opioid series
    0:08:31 about this supply side story.
    0:08:34 But despite all the death and damage since then,
    0:08:38 despite the anguish of millions of mourners and survivors
    0:08:43 since then, the overall problem has gotten worse.
    0:08:47 David Cutler wanted to find out why.
    0:08:48 So he started a research project in collaboration
    0:08:51 with the economist Travis Donahoe.
    0:08:53 Travis is currently a professor at University of Pittsburgh.
    0:08:57 And at the time we started out, he
    0:09:00 was a PhD student at Harvard in the Health Policy Program.
    0:09:04 You were an advisor to him?
    0:09:05 I was an advisor to him.
    0:09:07 And he actually grew up in West Virginia
    0:09:10 if there is an epicenter of the opioid epidemic
    0:09:13 in his West Virginia.
    0:09:15 So he was always, always interested in things
    0:09:19 having to do with opioids and pain and deaths due to that.
    0:09:25 I grew up in Huntington, West Virginia,
    0:09:26 which at the time I was in high school
    0:09:29 became widely known as a county that
    0:09:31 had the highest adult obesity and depression
    0:09:33 prevalence in the United States.
    0:09:35 That’s Donahoe.
    0:09:36 West Virginia also has the highest rate of drug overdose
    0:09:39 deaths in the US.
    0:09:41 Many people that I went to high school with,
    0:09:43 friends, have had opioid addiction over time.
    0:09:45 And there’s been a number of people that have overdosed.
    0:09:48 Travis wrote his dissertation on policies
    0:09:52 to address the opioid epidemic, particularly
    0:09:54 DEA intervention against distributors and dealers
    0:09:58 and so on.
    0:09:59 There’s a lot of literature on the opioid epidemic,
    0:10:02 including a lot of very good literature
    0:10:04 on the transition from people using legal opioids
    0:10:07 to people using illegal opioids and so on.
    0:10:11 And we were really puzzled first by the fact that, like, oh,
    0:10:15 my gosh, how long can this thing go on?
    0:10:17 But then by the fact that there are reasons why people
    0:10:21 stop taking things.
    0:10:23 Like, people learned that smoking was bad for them
    0:10:26 and they stopped.
    0:10:27 And not only that, they learned that the cigarette companies
    0:10:29 had been lying to them.
    0:10:31 And they were like, well, to heck with you guys,
    0:10:34 we don’t want to be using this product.
    0:10:37 So tobacco is a very addictive substance.
    0:10:41 Tobacco use has fallen well more than 50%
    0:10:44 since its peak just after World War II.
    0:10:47 Now talk for a moment about the levers that contributed
    0:10:50 to that, because it wasn’t by accident
    0:10:52 and it wasn’t cheap and it wasn’t easy.
    0:10:54 And there was a lot of regulatory and taxation
    0:10:56 power put to use, yes?
    0:10:58 There were a lot of public and private policies.
    0:11:02 There were public policies around taxation,
    0:11:05 around regulation of where you can smoke.
    0:11:08 There are private policies, like employers saying
    0:11:10 you can’t smoke in the workplace
    0:11:12 or you have to go outside to smoke.
    0:11:14 There was social pressure, peer pressure.
    0:11:18 No, you can’t smoke in my house.
    0:11:21 There’s what people were taught.
    0:11:24 Just the whole attitude, you really want to smoke?
    0:11:27 So it was a combination of public and private actions
    0:11:32 that led some people never to start smoking,
    0:11:36 some people to quit smoking,
    0:11:39 and others to help people stay off cigarettes.
    0:11:44 The net effect is that combustible cigarette use
    0:11:47 is very, very down.
    0:11:49 (upbeat music)
    0:11:51 So why haven’t opioids followed the same trajectory
    0:11:55 as cigarettes?
    0:11:57 That question brings us back to this new research
    0:11:59 by Donahoe and Cutler.
    0:12:01 – For a 30-year period,
    0:12:03 opioid overdose deaths have been increasing continuously.
    0:12:06 What we want to ask is why has that occurred?
    0:12:08 We know about things that have sparked it.
    0:12:11 We know about things that have exacerbated it,
    0:12:13 but what is it that would produce
    0:12:15 this kind of a continuous trend?
    0:12:17 They recently wrote up their findings in a paper
    0:12:20 with a title that only an economist could love,
    0:12:22 “Thick Market Externalities
    0:12:25 and the Persistence of the Opioid Epidemic.”
    0:12:27 And what is a thick market externality?
    0:12:31 In this case, it describes the fact that opioid users
    0:12:34 end up creating more opioid users.
    0:12:38 – What’s going on here is the idea,
    0:12:40 well, maybe I’ve hurt my knee,
    0:12:42 maybe I hurt my back or something.
    0:12:44 If there’s a lot of opioids around,
    0:12:46 I’ll bump into someone who has some,
    0:12:48 maybe I’ll experiment with them.
    0:12:50 Whereas if not, or if I have to go into the illegal market
    0:12:54 or I have to deal with someone I don’t know
    0:12:56 in some dangerous setting, maybe I’m not going to do that.
    0:12:59 So just the availability of the substance
    0:13:03 can encourage others to use it.
    0:13:06 And that’s what we look for
    0:13:09 and what we find evidence for.
    0:13:11 – Their evidence comes from several sources,
    0:13:13 like government figures on opioid deaths
    0:13:16 and the supply of drugs, but also from Facebook.
    0:13:20 – So it looks like it’s spreading through social networks.
    0:13:24 If one county has more deaths,
    0:13:26 nearby counties have more deaths.
    0:13:28 If one county has more deaths,
    0:13:30 areas of the country that have more Facebook friends
    0:13:32 than those areas also have more deaths.
    0:13:35 Sometimes the literal physical product
    0:13:38 will spread through networks.
    0:13:40 And sometimes just the idea,
    0:13:41 oh, when I was in pain, I got this opioid
    0:13:44 and maybe you should try this opioid.
    0:13:46 We have a quotation from someone who said,
    0:13:48 oh yeah, I got a call from a friend saying,
    0:13:50 I just tried this thing, it’s the greatest thing ever.
    0:13:53 You’ve just go tell your doctor you have back pain
    0:13:55 and ask for a prescription for it and you’ll love it.
    0:13:57 – When you look at data on initiation of opioids
    0:13:59 and other drugs, the typical age that a person initiates
    0:14:03 these kinds of drugs is pretty young.
    0:14:04 I would venture to guess that most people
    0:14:06 were not sitting in a void
    0:14:08 and then independently became curious about
    0:14:10 how to use heroin and then went out
    0:14:13 and figured out how to do that.
    0:14:14 It was probably that someone in their network
    0:14:16 was using heroin as well
    0:14:17 and then that ultimately influenced them
    0:14:19 to learn how to do it.
    0:14:21 – Do you know what is the median age
    0:14:23 of first use of opioids?
    0:14:26 – I don’t know that I know precisely,
    0:14:28 but I have seen the number 12 to 14 float around.
    0:14:31 – Oh my goodness.
    0:14:32 – So yeah, it’s quite young.
    0:14:33 – According to some fairly reputable government surveys,
    0:14:40 roughly half of the people who abuse opioids
    0:14:43 got them for free from a friend or relative.
    0:14:47 And where do all these pills come from?
    0:14:49 The Centers for Disease Control estimates
    0:14:52 that 57 million people, that’s nearly 20%
    0:14:55 of the US population,
    0:14:57 had at least one opioid prescription filled
    0:15:00 in a single year, 2017.
    0:15:02 For our earlier series on this topic,
    0:15:05 we spoke with Stephen Lloyd,
    0:15:07 a Tennessee physician and a recovering opioid addict.
    0:15:11 I asked him how he sourced his drugs.
    0:15:14 – At first, it was out of people’s medicine cabinets.
    0:15:17 For the longest time, I had a pretty much endless supply.
    0:15:19 If I came in your house
    0:15:20 and you had an old prescription left over,
    0:15:22 I walked out the door with it.
    0:15:23 And then the other way was doctor shopping.
    0:15:26 All my friends were doctors.
    0:15:27 And so I would just hit them up
    0:15:29 at different times for prescriptions.
    0:15:31 – Today, Stephen Lloyd is heavily involved
    0:15:33 in trying to fight the opioid epidemic.
    0:15:35 We will hear from him later in this series.
    0:15:38 As for the new research by David Cutler and Travis Donahoe,
    0:15:42 they estimate that spillover effects,
    0:15:45 social contagion basically,
    0:15:47 can explain roughly 90% of opioid deaths.
    0:15:51 Spillovers, they write,
    0:15:53 are the main reason deaths have increased for so long.
    0:15:57 – When people in one area use it,
    0:15:58 they tell their friends
    0:16:00 or they give the substance to their friends.
    0:16:02 And so both within the same area
    0:16:03 and then within other neighboring areas
    0:16:06 and within other areas where they have friends,
    0:16:09 even if they’re not neighboring,
    0:16:11 then you see usage and deaths go up there.
    0:16:14 And then you get all those feedback effects,
    0:16:16 like all those echoes,
    0:16:18 and it can get even bigger and bigger.
    0:16:20 And so that either significantly minimizes
    0:16:23 the extent to which it dies out
    0:16:25 or it actually creates this sort of unstable spiral
    0:16:29 where use one year translates
    0:16:31 into even more use the next year
    0:16:33 and even more the next year,
    0:16:35 30 years into an opioid epidemic
    0:16:38 would have been more than enough time
    0:16:40 under usual circumstances for opioids to die out.
    0:16:43 But because of these echo effects,
    0:16:46 it just keeps growing and growing.
    0:16:48 – Let’s talk about the previous and conventional explanations
    0:16:53 for the opioid epidemic
    0:16:55 and the fact that it’s continued to rise
    0:16:58 in volume and intensity.
    0:17:00 Let’s talk first about what others in your profession,
    0:17:03 particularly Angus Deaton and Anne Case,
    0:17:05 have called deaths of despair,
    0:17:07 which I believe is a self-explanatory phrase,
    0:17:09 but also something that probably most listeners
    0:17:11 are familiar with.
    0:17:12 What components of that argument
    0:17:14 as pertain to opioid deaths,
    0:17:16 do you think are accurate
    0:17:17 and which are perhaps inaccurate?
    0:17:19 – So their work is incredibly important.
    0:17:24 It’s among the most important things
    0:17:25 that has been written about public policy in decades.
    0:17:29 The idea behind it is that people are in despair
    0:17:33 either because of physical pain or mental pain
    0:17:36 or really stemming back to society
    0:17:38 that hasn’t worked the way they would like,
    0:17:41 and that that leads people to use illegal substances,
    0:17:45 partly as an out for it.
    0:17:47 So some of the specific things,
    0:17:49 like for example,
    0:17:50 there are more people in pain than there used to be,
    0:17:53 but the increase in pain is nowhere near as big
    0:17:56 as the increase in use of opioids.
    0:17:58 – Now, David, you have written a paper on this very idea,
    0:18:01 I believe with your colleague, Ed Glazer, correct?
    0:18:03 – That’s correct.
    0:18:05 What’s happened over time
    0:18:06 is not that there are just more people in pain,
    0:18:09 although there absolutely are,
    0:18:11 but the people in pain are doing different things.
    0:18:14 Once opioids were sort of safe and effective,
    0:18:17 it became, oh, you have a toothache, here’s opioids.
    0:18:20 Oh, you’ve got to hurt back because of work,
    0:18:23 oh, use opioids.
    0:18:24 Oh, you’re down and out,
    0:18:25 and that’s presenting with psychological pain,
    0:18:29 but also physical pain manifestations, use opioids.
    0:18:33 And so it is true that there is this large share of people
    0:18:37 in physical and mental pain.
    0:18:40 The way that the medical system and people have responded
    0:18:43 is different than it used to be,
    0:18:45 and it involved trying to medicalize it and treat it.
    0:18:48 That’s problematic here when the treatment is not effective
    0:18:51 and in fact is addictive.
    0:18:54 For God’s sakes, if the treatment is worse than the disease,
    0:18:57 it’s really a terrible thing.
    0:18:59 – One thought I had while reading your new paper
    0:19:02 on the social spillovers of opioid abuse
    0:19:05 is that the deaths of despair umbrella
    0:19:09 explains many opioid overdose deaths
    0:19:12 as a result of loneliness and isolation.
    0:19:16 But what your paper is arguing
    0:19:18 seems to be kind of the opposite of that,
    0:19:19 which is that it’s not isolation or loneliness,
    0:19:22 or maybe it is loneliness,
    0:19:23 but it’s not isolation, it’s actually connection
    0:19:27 that without connection afforded by the internet particularly,
    0:19:32 that this epidemic would not have continued to grow.
    0:19:34 Is that a fair read?
    0:19:36 – Yes, the connection is absolutely fundamental here.
    0:19:40 Of course, these connections are different
    0:19:41 than the kinds of connections that Anne and Angus
    0:19:44 are writing about and that they’re talking about
    0:19:46 meaningful connections in your life.
    0:19:48 And the internet here is about where can I buy something
    0:19:51 or where can I obtain the product cheaply,
    0:19:54 which is a different kind of connection.
    0:19:56 – So that’s one economist, David Cutler,
    0:20:00 talking about how his research,
    0:20:01 which shows that a certain kind of connectivity
    0:20:04 has helped prolong the opioid epidemic,
    0:20:07 can square up with some other economists’ argument
    0:20:10 about deaths of despair.
    0:20:13 But what does a non-economist think
    0:20:15 of David Cutler’s argument?
    0:20:17 – I would praise two things about the Cutler paper.
    0:20:20 That, again, is Keith Humphries,
    0:20:22 the Stanford Addiction Researcher and Drug Policy Advisor.
    0:20:25 – So one is it drives non-economists crazy
    0:20:29 when economists show up in a new area
    0:20:31 and act as if no one has studied it before.
    0:20:33 So I actually first looked at the references.
    0:20:35 Have they actually read anything about addiction?
    0:20:37 And they have, so that’s good.
    0:20:38 Second thing is they are absolutely correct
    0:20:41 that social processes spread addiction
    0:20:44 much the same way as they might spread something like COVID.
    0:20:47 People who are using invite other people to use with them.
    0:20:50 Sometimes they do that ’cause they’re like,
    0:20:52 well, I need to sell to keep my own habits
    0:20:54 so this is someone I could sell to.
    0:20:55 But oftentimes it’s friendship, it’s fun,
    0:20:57 let’s do this together.
    0:20:58 And particularly if you’re in the early stages of drug use,
    0:21:01 it can look very compelling.
    0:21:03 If you’re deeply addictive and you’re homeless,
    0:21:04 it’s pretty hard to persuade someone,
    0:21:05 hey, you wanna live like me.
    0:21:07 But if it’s a party, so that part is true.
    0:21:10 – But Humphries, as a drug expert,
    0:21:12 also has some critiques of the economist’s paper.
    0:21:15 There’s two things in analysis
    0:21:17 that I think are pretty seriously questionable.
    0:21:20 First is they’re trying to explain
    0:21:21 why do we keep having this epidemic after 25 years
    0:21:25 when the average person would say,
    0:21:26 I don’t wanna do that and that would help make it die off.
    0:21:29 And second, the police would shut it down.
    0:21:31 But I’ll just say there’s another epidemic,
    0:21:34 25 years that has also gotten more severe
    0:21:36 and that’s alcohol.
    0:21:37 Alcohol deaths are up and they don’t look at that.
    0:21:39 Why don’t we shut the alcohol industry down
    0:21:41 because it’s a legal industry.
    0:21:43 And that is a big reason why the opioid epidemic
    0:21:46 has gone on so long.
    0:21:47 They had gold-plated protection as a legal industry.
    0:21:51 One of the most remarkable things that happened,
    0:21:53 the Drug Enforcement Administration
    0:21:55 caught distributors delivering a million pills
    0:21:58 to towns with 300 people.
    0:22:00 I’m not exaggerating.
    0:22:01 And you think that’s gonna stop them.
    0:22:03 The distributors went to their friends in Congress
    0:22:05 and got a new law passed that basically stopped the DA
    0:22:08 from doing that.
    0:22:09 – We went back to Cutler and Donahoe
    0:22:11 to ask what they thought of these critiques.
    0:22:13 They wrote back to say that they agree
    0:22:15 that insufficient regulation is an important reason
    0:22:18 that the epidemic has lasted so long,
    0:22:20 but that it doesn’t conflict with their argument
    0:22:22 about social spillovers.
    0:22:24 In towns that had pill mills,
    0:22:26 like Keith Humphries was talking about,
    0:22:27 a million pills shipped to a town of 300,
    0:22:30 opioid deaths continued to rise
    0:22:33 after those pill mills were shut down.
    0:22:36 And Cutler and Donahoe say that alcohol
    0:22:39 may actually have social spillover dynamics
    0:22:41 similar to what they have observed with opioids.
    0:22:44 The persistence in demand for alcohol, they wrote,
    0:22:48 would be related to its near ubiquity in social settings.
    0:22:53 Think about that for a minute,
    0:22:54 the next time you have a drink with friends or colleagues.
    0:22:58 Keith Humphries had another problem
    0:23:00 with the Economist’s paper.
    0:23:02 This one has to do with how they measured opioid overdoses.
    0:23:05 – They’re treating overdoses as an index of demand
    0:23:09 and they aren’t an index of demand.
    0:23:11 Overdosed deaths are a function of how often somebody uses
    0:23:15 and how risky each episode of use is.
    0:23:18 – The risk he is describing is the likelihood
    0:23:20 that a given drug user will overdose in a given year.
    0:23:24 – In the 90s people using Vicodin, maybe it was one in 200
    0:23:28 and then Oxy raised it to one in 100.
    0:23:30 And then heroin raises it to, you know, one in 50.
    0:23:34 And with Fendle, maybe it’s as much as one in 20
    0:23:36 for a year of use.
    0:23:37 So when you say, oh, deaths are going up,
    0:23:39 it must mean demand is going up.
    0:23:41 No, actually demand could be dropping.
    0:23:43 The problem is the risk of use are going up.
    0:23:47 The number of people who say I’m initiating opioids is dropping.
    0:23:50 And the number of people say they’re using Fendle
    0:23:52 is nowhere near what it was.
    0:23:54 But the number of people who were saying
    0:23:55 they were using the pills back when that was the heyday,
    0:23:57 it’s just that it’s so deadly.
    0:23:59 – And that’s really the big issue,
    0:24:02 the potency of the drugs.
    0:24:04 We will get into that later in this episode.
    0:24:07 Cutler and Donahoe told us that their measure of demand
    0:24:09 was not just about overdose deaths.
    0:24:12 Their analysis looked at, quote,
    0:24:14 the total potency adjusted quantity of opioids
    0:24:17 that are sought.
    0:24:18 That is the number of people seeking opioids
    0:24:21 multiplied by the amount they want to use.
    0:24:24 They wrote, there is a lack of good data
    0:24:27 on how many people are using various substances
    0:24:29 and how much they are using.
    0:24:31 Thus, it is very hard to know what is happening
    0:24:34 to the number of people in the market
    0:24:36 for a drug like illicitly made Fentanyl.
    0:24:39 Everyone in the field wishes we knew more.
    0:24:42 Coming up after the break,
    0:24:45 what else do we not know about how to end
    0:24:48 the opioid epidemic?
    0:24:50 This is Freakin’omics Radio.
    0:24:51 I’m Stephen Dubner.
    0:24:52 We will be right back.
    0:25:05 Fentanyl is a synthetic opioid
    0:25:07 that’s more than 50 times as powerful as morphine.
    0:25:11 In the US, it’s responsible for about two-thirds
    0:25:14 of fatal drug overdoses.
    0:25:16 As I mentioned earlier, Fentanyl started out
    0:25:18 as a hospital drug for anesthesia and pain relief.
    0:25:22 The World Health Organization still lists it
    0:25:24 as an essential medicine for the management of cancer pain.
    0:25:28 Here is Keith Humphries from Stanford.
    0:25:31 It’s terrific.
    0:25:32 I worked in hospice for a number of years
    0:25:34 for people with late-stage bone cancer.
    0:25:36 A fentanyl patch can give them relief
    0:25:37 when nothing else can.
    0:25:38 And it had been recognized for a long time
    0:25:41 that this could really be a blockbuster
    0:25:44 on the illicit market.
    0:25:45 And some criminal gangs tried to introduce it.
    0:25:48 There was an outbreak around 2000.
    0:25:50 There was another about five years after.
    0:25:52 But they were domestic groups.
    0:25:54 They were small.
    0:25:55 And law enforcement was very good at jumping on them
    0:25:57 right away and shutting them down.
    0:25:59 But that changed as the booming black market
    0:26:02 for fentanyl in the U.S. attracted foreign suppliers.
    0:26:06 We live in a globalized economy, right?
    0:26:09 And China, which has a massive chemical industry,
    0:26:12 a massive pharmaceutical industry,
    0:26:13 and an export-led economy,
    0:26:16 has a lot of people who wouldn’t mind earning
    0:26:17 a little extra money on the weekend.
    0:26:19 And they started to do it.
    0:26:20 And that combines with the technology of the internet
    0:26:23 that they began selling, what are called precursors,
    0:26:25 the stuff I use to make the fentanyl over into North America.
    0:26:30 For example, into Mexican suppliers.
    0:26:31 Also, sometimes just sending fentanyl directly in the mail.
    0:26:34 Fentanyl is so potent that you could,
    0:26:37 let’s say you had a dealer in Dayton, Ohio,
    0:26:39 you could put it in an envelope
    0:26:40 that was something that might have a Christmas card in it.
    0:26:43 Plus, this is not like in the old days
    0:26:45 where maybe, you know, Guinea-Bissau is growing a plant
    0:26:48 that’s turned into drugs.
    0:26:49 And a superpower can pressure Guinea-Bissau.
    0:26:51 You can’t really pressure a nuclear-armed superpower
    0:26:54 like China to do anything.
    0:26:55 – Has this supply to the U.S.
    0:26:57 been significantly constrained or not?
    0:26:59 – The most important thing that’s happening in drugs
    0:27:01 is the departure of drugs from in their agricultural base
    0:27:04 that they had for thousands of years.
    0:27:06 Let’s say you’re running a heroin business
    0:27:07 and I’m running a fentanyl business.
    0:27:09 What do you have to do?
    0:27:10 Well, you got to get some arable land,
    0:27:12 probably in a place with weak government,
    0:27:14 dodgy local politics.
    0:27:15 – Afghanistan looks good.
    0:27:16 – Right, but now you have to pay off a warlord.
    0:27:18 And you got to find peasant labor
    0:27:19 and you got to protect the farm.
    0:27:21 You got to make sure no other warlord burns the crop.
    0:27:23 And then you got to get across the border.
    0:27:24 Well, that means either smuggling costs or bribery costs.
    0:27:27 Then you got to put it in a boat and it’s big.
    0:27:29 And it’s bulky in thousands of miles.
    0:27:31 And then the Coast Guard grabs it
    0:27:32 and then you got away from the next growing season.
    0:27:34 And then there’s blight or a drought.
    0:27:36 Whereas me, I just like, hey, I need some fentanyl bill.
    0:27:39 Can you whip it up in the sink?
    0:27:40 Yep, have it for you in a couple hours.
    0:27:42 So I’m going to put you out of business.
    0:27:44 My production costs are about 1% of your production costs.
    0:27:48 And that is what is happening.
    0:27:49 Right now in California, heroin is very hard to find.
    0:27:53 I know people who have, you know, addicted.
    0:27:54 So I can’t get it anymore.
    0:27:55 So a lot of the traditional things that countries used to do
    0:27:59 to suppress the trade are irrelevant.
    0:28:01 When you pull up plants, there are no plants.
    0:28:03 When a drug is that potent and that cheap,
    0:28:06 it’s hard for government and law enforcement
    0:28:08 to do much about it.
    0:28:10 I testified to the Senate about this just recently.
    0:28:13 Understandably, they want fentanyl kept out of this country.
    0:28:17 But it’s so compact that our entire consumption,
    0:28:20 at least the Rand people who are very smart at this kind of stuff,
    0:28:23 think it’s only like five or 10 metric tons a year.
    0:28:26 That’s a truck, a truck.
    0:28:29 That’s pretty easy to hide stuff that small.
    0:28:31 So it’s very hard to keep it out of the country.
    0:28:33 Most of the fentanyl that comes into the country
    0:28:40 comes through legal border crossings.
    0:28:43 That, again, is David Cutler,
    0:28:44 the Harvard healthcare economist.
    0:28:47 This is not people bringing quantities of fentanyl
    0:28:50 with them through illegal immigration.
    0:28:53 It’s basically coming into the country
    0:28:56 through a legal method.
    0:28:58 And then, from there, going through the supply chain
    0:29:01 to wind up being distributed to users.
    0:29:04 It gets either incorporated into heroin
    0:29:06 or pressed into pills that say it’s oxycontin
    0:29:10 when it’s not or combined with methamphetamines
    0:29:14 or any number of other ways, and then people die from that.
    0:29:19 And I assume the concentration is far out of whack, yes?
    0:29:22 The concentration is far out of whack
    0:29:24 and the potency varies a lot from batch to batch
    0:29:28 because you have to dilute it.
    0:29:30 And so that’s part of a high level of deaths
    0:29:32 is I may be used to a certain dose,
    0:29:35 but if you don’t mix it correctly,
    0:29:37 I may get more dosage than that
    0:29:40 and that can be a big problem.
    0:29:42 – Now, I know very little about drug dealing,
    0:29:46 but I don’t understand why it would be
    0:29:49 that drug sellers, drug dealers,
    0:29:52 would want to include a fatal substance
    0:29:55 because they’re killing their customers.
    0:29:57 Can you explain that?
    0:29:58 – There are different versions of the answer to this.
    0:30:02 One version is exactly yours, which is they don’t mean to,
    0:30:05 but they sometimes do by accident
    0:30:07 because the mixing isn’t so great.
    0:30:09 A second version is what you really want
    0:30:13 if you’re in the market is you want to know
    0:30:16 that the person has a potent batch.
    0:30:19 And so it doesn’t hurt if the batch has killed someone else
    0:30:24 that may attract more customers to you.
    0:30:27 Gosh, if someone died using a given dealer’s fentanyl,
    0:30:31 that must mean it was pretty good.
    0:30:33 – The current supply of street drugs in the US
    0:30:37 like cocaine and methamphetamine
    0:30:40 contains a lot of fentanyl.
    0:30:43 In a recent study of drug users in New York City,
    0:30:45 more than four out of five people tested positive
    0:30:48 for fentanyl, but only one in five said
    0:30:51 that their fentanyl consumption was intentional.
    0:30:54 Given this widespread contamination
    0:30:58 and the massive overdose risk
    0:31:00 and all the other suffering that opioids have caused
    0:31:03 over the past couple of decades,
    0:31:05 it may be tempting to take a hard line stance
    0:31:08 against drugs, full stop.
    0:31:11 Keith Humphries is more measured than that.
    0:31:14 – I think people rhetorically,
    0:31:16 there are people saying all drug use is bad.
    0:31:18 But from a science viewpoint,
    0:31:20 when you realize what is a drug
    0:31:22 and how broad that category thing that is,
    0:31:24 you realize very few of us go through our life
    0:31:26 without taking drugs.
    0:31:28 – Do I have to put down my caffeine right now?
    0:31:30 – There you go.
    0:31:31 I mean, I’ve often brought that up.
    0:31:32 You know, I love caffeine.
    0:31:33 I don’t have a problem with it.
    0:31:35 If I had to choose between caffeine and my children,
    0:31:37 I could make that decision, but I would miss them.
    0:31:40 I would really miss them.
    0:31:41 I’ve been in meetings where people condemn
    0:31:43 the evil of drugs and then they all go out
    0:31:45 and have a drink as if alcohol were a drug.
    0:31:47 We go to a doctor and we get drugs that save our lives, right?
    0:31:51 When you realize that drugs are not just the thing
    0:31:53 that’s in the paper connected to a crime story
    0:31:55 about a deal gone wrong and somebody got shot,
    0:31:59 you realize it’s almost a universal human thing
    0:32:01 to take drugs.
    0:32:01 So really what we’re arguing about is when do we take them
    0:32:03 and how and for what reasons and how it’s monitored.
    0:32:06 I have been a proponent of a medication called naloxone,
    0:32:10 which is an opioid antagonist.
    0:32:12 So what that means is when you take an opioid,
    0:32:14 it binds to a particular receptor in your brain
    0:32:16 and naloxone essentially goes to that same receptor
    0:32:19 and knocks that opioid out.
    0:32:20 Now, is there any possibility that somebody might take more
    0:32:24 opioids knowing their friend was there with naloxone?
    0:32:27 That is definitely possible.
    0:32:28 We know risk compensation happens in lots of behaviors.
    0:32:30 People drive more quickly when they have their seatbelt on.
    0:32:33 However, the equation is risk compensation
    0:32:36 minus how effective the safety device is, right?
    0:32:40 So if I think how much more risky drug use would naloxone cause?
    0:32:44 I’d say it’s pretty small amount.
    0:32:46 How different is it to overdose with naloxone and without it?
    0:32:49 Oh boy, that’s a huge effect.
    0:32:51 When you have somebody who literally is dying
    0:32:53 a few moments later, they’re breathing again,
    0:32:55 which is pretty incredible.
    0:32:57 – When I say harm reduction,
    0:32:59 is that a phrase that you generally embrace
    0:33:01 or do you feel it’s come to cover too much ground perhaps?
    0:33:04 – Well, if you want, you know,
    0:33:05 five definitions of harm reduction, talk to three people.
    0:33:09 So I try as I do with lots of words people argue about a lot
    0:33:12 is I often start to say, well, tell me what you mean by that.
    0:33:15 I hope none of us wake up in the morning
    0:33:17 trying to do harm, right?
    0:33:18 So we’d like to have less harm.
    0:33:20 And it shouldn’t be overdrawn as some people do the distinction
    0:33:24 say between harm reduction and treatment
    0:33:26 because the truth is many people who go to treatment
    0:33:29 end up continuing to use but less in a less dangerous way.
    0:33:33 And a number of people get in contact with harm reduction
    0:33:36 that ultimately ends with them deciding
    0:33:38 that they don’t want to use drugs at all.
    0:33:40 Sometimes the difference gets overstated,
    0:33:42 the clans start to fight with each other.
    0:33:44 I just look at this as a public health,
    0:33:45 public safety thing like what is the impact?
    0:33:47 And if it’s what I consider a good impact,
    0:33:49 then I’m in favor of it.
    0:33:50 – This gets us into another tricky area of drug policy.
    0:33:57 Some people who argue for harm reduction
    0:34:00 think the best way to get there
    0:34:01 is to decriminalize drug possession.
    0:34:04 That would remove some of the stigma of drug use.
    0:34:07 It would allow for more safety regulations.
    0:34:09 It would free up law enforcement resources
    0:34:11 for other problems.
    0:34:13 One US state, Oregon recently tried decriminalization.
    0:34:17 – Yeah, at the end of 2020,
    0:34:19 the people of Oregon voted in the general election
    0:34:22 to remove all criminal penalties for drug use.
    0:34:26 And practically speaking,
    0:34:27 also reduce penalties for drug dealing.
    0:34:29 So that changed the character of the state
    0:34:31 and there was unfortunately a big increase in overdoses.
    0:34:35 And I noticed I go to Oregon a lot,
    0:34:37 a lot more public drug dealing
    0:34:38 which has bad effects on neighborhoods.
    0:34:40 Now, it was also a pandemic, right?
    0:34:42 So things could have easily gotten worse anyway.
    0:34:45 But the faith that the advocates had
    0:34:48 that if you removed all pressure
    0:34:50 and you removed all shame from, you know,
    0:34:54 sitting on a park bench using fentanyl,
    0:34:56 then people would seek out care
    0:34:59 proved to be completely incorrect.
    0:35:01 – Did that surprise you and others in the field?
    0:35:03 – Me, no.
    0:35:05 I just think about the neuroscience,
    0:35:06 I think about the biology of reward
    0:35:09 is that that would have been true
    0:35:10 if the condition were, say, depression.
    0:35:13 Depression feels bad every day.
    0:35:15 People are so happy to get rid of depression
    0:35:17 if you can get rid of it.
    0:35:18 Drug use doesn’t feel bad.
    0:35:19 Drug use feels incredible.
    0:35:21 In those short moments, you get this great reward.
    0:35:23 I mean, that’s why I say,
    0:35:24 why does this person give up their family,
    0:35:26 their health, their home for this?
    0:35:27 It’s because in the short term, it feels great.
    0:35:30 And so most people who seek help are under some pressures.
    0:35:34 There’s some countervailing force.
    0:35:36 The spouse says, you keep doing this,
    0:35:38 I’m taking the kids and I’m moving out.
    0:35:39 You know, boss says, you show up high to work one more time,
    0:35:42 you’re fired.
    0:35:44 – And you’re saying making things more easily available
    0:35:46 does not increase that countervailing force.
    0:35:49 – No, just the opposite.
    0:35:50 And there was also sort of rhetoric.
    0:35:51 It’s wrong to think anything negative about it.
    0:35:53 We need to fully destigmatize the behavior.
    0:35:55 But you know, when people come in for care,
    0:35:58 it’s very often because they do feel ashamed.
    0:36:00 They feel like, you know, I’m letting my family down.
    0:36:02 I’m letting myself down.
    0:36:03 – So I don’t want to say, are you a fan of stigma,
    0:36:06 but do you see a useful role of stigma
    0:36:08 in the way society thinks about drugs?
    0:36:10 – Absolutely.
    0:36:11 So when I was growing up,
    0:36:12 I grew up in West Virginia in the 60s and 70s.
    0:36:15 Two things considered funny or not considered funny anymore.
    0:36:18 One was drunk driving and the other one was hitting your wife.
    0:36:20 People joked about these things.
    0:36:22 Now they’re deeply stigmatized and I’m glad
    0:36:25 because that is a signal to people
    0:36:26 that those are wrong things to do.
    0:36:28 So there has to be some pressure.
    0:36:31 And I say that same time saying like,
    0:36:32 I’ve always been against forever throwing people
    0:36:35 into a cell for the mere act of using a substance.
    0:36:39 But there’s plenty of smarter things we can do than that.
    0:36:42 – After the break,
    0:36:45 what are some of those smarter things?
    0:36:47 I’m Stephen Dubner,
    0:36:48 and this is the first episode in a two-part series
    0:36:51 about why the opioid epidemic is still getting worse.
    0:36:55 If you like listening to Freakonomics Radio
    0:36:57 and learning along with us,
    0:36:59 I hope you will tell other people to listen to it.
    0:37:01 That is a great way to support the podcasts you love.
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    0:37:09 That helps too.
    0:37:10 Thank you much, Lee.
    0:37:11 We will be right back.
    0:37:22 – In 2020, the Stanford drug policy expert, Keith Humphries,
    0:37:26 led a commission between his university
    0:37:28 and the Lancet Medical Journal in Britain.
    0:37:31 – It’s one of the most influential journals
    0:37:34 in terms of global health.
    0:37:35 People read it everywhere.
    0:37:36 And they create commissions
    0:37:37 to look at global health challenges.
    0:37:40 And so there’s a Lancet commission on diabetes,
    0:37:42 Lancet commission on the health of children,
    0:37:44 and Lancet commission on malaria.
    0:37:45 And then usually they wanted to do one
    0:37:48 just on a couple of countries, the US and Canada.
    0:37:51 And that was because of our opioid crisis.
    0:37:54 It was so bad, they said, this isn’t global yet,
    0:37:56 but let’s do something about it now.
    0:37:59 – The commission was asked to come up with solutions
    0:38:01 that would cut opioid deaths
    0:38:02 from pharmaceutical marketing
    0:38:04 to medical education to policy.
    0:38:07 Humphries has even more suggestions.
    0:38:10 – You wanna make drugs as hard to get as possible.
    0:38:12 You cannot eliminate them.
    0:38:14 That is impossible,
    0:38:15 but you can certainly raise search costs.
    0:38:18 There’s a thing called drug market intervention
    0:38:19 that the police, community, health do together
    0:38:21 to close down open air drug markets.
    0:38:24 Why do those markets exist?
    0:38:25 They are not to serve the people in the neighborhood.
    0:38:27 If you were in the neighborhood,
    0:38:28 you would know the dealer, the dealer would know you.
    0:38:30 They’re so that people from outside the neighborhood
    0:38:32 can rapidly find,
    0:38:33 a dealer and dealer can rapidly find customers.
    0:38:35 And that just has all these destructive effects.
    0:38:37 You can close those down
    0:38:38 and that’s something that’s definitely helpful.
    0:38:41 – That’s one suggestion.
    0:38:42 What else does Humphries have?
    0:38:44 – With the seven, eight million people
    0:38:46 at any given time you’re on probation and parole,
    0:38:48 we should be drug testing and alcohol testing all of them,
    0:38:52 regardless of what they’re arrested for
    0:38:54 and giving rewards and penalties based on their use,
    0:38:58 immediate swift and certain rewards.
    0:38:59 I’m not talking about violating them back
    0:39:00 to their original sentence,
    0:39:02 but you could have things like if you go through a week
    0:39:04 and you don’t use cocaine,
    0:39:05 we’ll knock a week off in the end of your parole sentence.
    0:39:08 Or the other way,
    0:39:09 I’m afraid we’re gonna add another week on your parole
    0:39:10 because you didn’t do that.
    0:39:12 – Humphries himself has done some work
    0:39:14 on a program like this for alcohol abuse.
    0:39:16 It’s called 24/7 sobriety.
    0:39:19 – It was invented by a county prosecutor
    0:39:21 named Larry Long, a remarkable guy.
    0:39:23 He was seeing people he grew up with
    0:39:26 in a small town in South Dakota
    0:39:27 cycling through the court over and over
    0:39:28 with alcohol problems.
    0:39:29 And he felt bad for them ’cause he knew,
    0:39:31 we threaten you, we take away your car,
    0:39:32 we throw you in jail, nothing works.
    0:39:34 And he said, the problem isn’t driving,
    0:39:36 the problem is drinking.
    0:39:37 – 24/7 sobriety is a court mandated program
    0:39:40 for people who have been arrested multiple times
    0:39:43 for drunk driving.
    0:39:44 It involves constant and frequent testing.
    0:39:47 – Every morning you have to come in
    0:39:49 and you blow a breathalyzer.
    0:39:51 If it shows negative, you get immediate reward.
    0:39:53 Have a great day, Keith, another day of freedom.
    0:39:55 If, on the other hand, it’s positive,
    0:39:57 there’s an immediate consequence.
    0:39:58 You’re arrested on the spot, not maybe, certainly,
    0:40:02 and you are held in a cell for just one night.
    0:40:04 But it starts that night, immediate.
    0:40:07 Now, you’d think in a way,
    0:40:08 a lot of these folks have been in prison,
    0:40:09 why would they care about one night in jail system?
    0:40:12 It’s because it’s a swift and certain consequence
    0:40:15 and all those other consequences in criminal justice
    0:40:18 are very probabilistic and distant.
    0:40:20 So when I heard out this program,
    0:40:21 I was in the administration,
    0:40:23 I thought, oh, come on, half these people
    0:40:24 are gonna show up drunk and the other half
    0:40:25 are gonna be rampaging around the countryside.
    0:40:27 And I went there the first morning,
    0:40:29 I remember this in Sioux Falls
    0:40:31 and watched 200 people go straight through,
    0:40:34 all 200 showed up, all 200 blew negative.
    0:40:37 In South Dakota now they’ve done over 10 million tests
    0:40:39 and the success rate,
    0:40:40 meaning the proportion of times people show up
    0:40:42 and are not drinking is 99.1%.
    0:40:45 – The 24/7 sobriety program also produced
    0:40:48 a significant reduction in repeat arrests for drunk driving.
    0:40:52 – Violence against women also went down dramatically.
    0:40:55 When you take alcohol out of somebody’s life,
    0:40:57 other good things happen.
    0:40:58 – So that’s one set of ideas
    0:41:00 that Keith Humphries thinks could help cut opioid deaths.
    0:41:03 What else?
    0:41:04 – We could definitely have a decent addiction treatment system,
    0:41:07 which we do in some places, but not in most of the country,
    0:41:11 treating addiction like a serious chronic illness,
    0:41:15 meaning it would be core to our healthcare function.
    0:41:18 I think we’ve come to that with smoking.
    0:41:20 Your doctor now is very comfortable
    0:41:22 talking to you about your tobacco use
    0:41:23 and also, you know, do you want to make a red gum
    0:41:25 or do you want to try some xiban or whatever?
    0:41:27 We need to do that for all the other substances as well.
    0:41:30 We need to save as many lives as we can in the meantime.
    0:41:33 Now lock zone is, you know,
    0:41:35 a lifesaver, syringe service programs
    0:41:37 that reduces the spread of infectious disease.
    0:41:39 That is certainly a very worthwhile thing to do as well.
    0:41:42 And then the last thing is, particularly opioids,
    0:41:45 you have to remember that the American opioid crisis
    0:41:47 didn’t start on the streets.
    0:41:48 It started in hospitals and doctor’s clinics.
    0:41:51 And we need to do a much better job
    0:41:54 regulating legal producers of drugs.
    0:41:57 It’s interesting how common it is to assert
    0:42:00 that if only these things were legal,
    0:42:02 we wouldn’t have these problems.
    0:42:03 Remember, the biggest problems we have
    0:42:05 are all with legal drugs.
    0:42:07 Eight million human beings a year die from smoking
    0:42:09 on this planet.
    0:42:10 That’s 10 times more than all the illicit drugs
    0:42:12 put together, so you gotta regulate adequately.
    0:42:14 – What about the demand side?
    0:42:16 – The consumption is very skewed,
    0:42:18 so you have very high consumption people.
    0:42:20 Those are great targets for treatment.
    0:42:22 Often, in fact, the first line treatment is an opioid,
    0:42:24 which strikes some people as, you know,
    0:42:26 how would you treat an opioid with an opioid?
    0:42:27 But they’re dramatically safer opioids
    0:42:30 like buprenorphine and methadone relative to fentanyl
    0:42:33 that give people stability and they can do things like,
    0:42:36 you know, hold a job, be with their families
    0:42:38 and that kind of thing.
    0:42:39 Every time you take one of those folks out,
    0:42:40 it’s a huge hit to demand.
    0:42:43 And then there’s the investments need to be made
    0:42:44 on the prevention side.
    0:42:46 This is the thing that is the hardest to get
    0:42:48 everybody interested in because we are consumed
    0:42:52 understandably by the suffering that is right before us.
    0:42:55 But if you look at other epidemics that people
    0:42:57 my age have lived through, you know, COVID, HIV, AIDS,
    0:43:01 those were not solved by saying,
    0:43:03 “Let’s wait ’til people get really sick
    0:43:05 “and then spend a lot of resources to try to help them.”
    0:43:08 They were ended by getting people into recovery who were sick,
    0:43:11 but even more importantly, stopping new cases.
    0:43:14 – Right, so what’s the version of vaccine
    0:43:16 in the opioid problem?
    0:43:17 – You do as much as you can to avoid exposure,
    0:43:20 particularly when people are young.
    0:43:23 We still have a problem of like one in eight people
    0:43:25 go into an emergency room with a twisted ankle,
    0:43:27 comes out with an opioid prescription.
    0:43:29 We still have doctors prescribing opioids
    0:43:30 to teenagers for headaches.
    0:43:32 So you want to reduce that exposure,
    0:43:34 but you also want to reduce the demand.
    0:43:36 And I emphasize that time in life, by the way,
    0:43:38 because the neuroscience shows our brains
    0:43:40 are the most plastic and changeable when you’re young.
    0:43:43 Is anyone who’s trying to learn a language
    0:43:45 in their 50s knows, right?
    0:43:47 So just like you can pick up your French,
    0:43:48 your Spanish really fast when you’re a teenager
    0:43:51 or even younger, that is where most addictions start.
    0:43:54 If you make it to 25 without an addiction,
    0:43:56 you will probably never develop one.
    0:43:59 That’s where prevention and health promotion comes in.
    0:44:01 When I say that, a lot of people’s eyes glaze over,
    0:44:03 they think about dare, which was very broadly distributed
    0:44:07 and didn’t really–
    0:44:08 – And not successful.
    0:44:09 – And not successful.
    0:44:10 And you can couple that with the picture of the egg,
    0:44:13 this is your brain on drugs.
    0:44:14 – I always thought that egg would make stoners hungry.
    0:44:16 (both laughing)
    0:44:18 Sorry.
    0:44:19 – That’s a way to flip the discussion.
    0:44:21 But thinking about that, as that’s what prevention is,
    0:44:24 it’s kind of like thinking,
    0:44:25 the Tandy Radio Shack 80 is what computers are about.
    0:44:29 That’s a very long time ago.
    0:44:31 And since that time, there’s been really
    0:44:33 well-developed prevention.
    0:44:35 – Can you just describe generally what sort of program
    0:44:37 that is what you’re talking about?
    0:44:39 – You’re going into this period of life
    0:44:41 when kids are about 10, 11, 12,
    0:44:43 and you’re making investments in their core capacity.
    0:44:46 You don’t walk in and just say, don’t use drugs,
    0:44:49 but you’re helping them things like,
    0:44:50 how do you learn how to recognize and manage your emotions?
    0:44:53 What are some ways to cope with challenges?
    0:44:55 How do you connect with pro-social kids?
    0:44:58 How do you connect to adults?
    0:45:00 Getting them connected to community structures
    0:45:02 that they can do instead of drugs.
    0:45:04 That might be cultural, civic, religious,
    0:45:06 athletic organizations, whatever,
    0:45:08 where there’s joy and there’s fun and there’s connection,
    0:45:10 but it’s not center on substances.
    0:45:12 – Are drugs even part of that conversation?
    0:45:14 – Absolutely.
    0:45:15 This is an unhealthy, as is alcohol, as is tobacco,
    0:45:18 but it’s a lot broader than that.
    0:45:20 And the reason that matters is
    0:45:22 all the things we worry about with kids,
    0:45:25 the risk factors for them overlap like 75, 80%.
    0:45:29 So there’s programs like we want to stop eating disorders,
    0:45:31 we want to stop depression, we want to stop self-harm,
    0:45:33 we want to stop smoking.
    0:45:34 But the thing is like, why do kids do all those things?
    0:45:37 And it comes back mostly to these core things
    0:45:39 of inability to deal with emotions and ability to connect
    0:45:42 with others.
    0:45:43 And so you focus on those.
    0:45:44 And then for one kid, the benefit is he was gonna become
    0:45:48 a drug user as a teen, he won’t.
    0:45:49 But for the other kid,
    0:45:50 that kid was never gonna become a drug user,
    0:45:51 but she was gonna be really depressed
    0:45:54 or have bad body image and self-harm
    0:45:56 and she’s not gonna do that.
    0:45:57 So you see all these benefits as people go through
    0:45:59 and 10 year studies now
    0:46:01 and more likely to graduate from college.
    0:46:03 Let’s let you to be carrying a gun as a teenager.
    0:46:06 So those are the kind of investments we need to make
    0:46:08 in kids.
    0:46:09 It’ll help our drug problem.
    0:46:10 It’ll help a lot of other problems too.
    0:46:12 – Keith Humphries plainly has a lot of ideas
    0:46:18 about how to best fight the opioid epidemic.
    0:46:22 Many of them involve government oversight and support,
    0:46:25 which given his policy-making background makes perfect sense.
    0:46:29 Next time on the show, we will get a different perspective.
    0:46:33 – I think the opioid epidemic
    0:46:34 is this generation’s HIV and AIDS.
    0:46:37 If you parallel that to what we’re seeing
    0:46:39 with the opioid epidemic, there are so many similarities.
    0:46:42 What’s the biggest thing that prevents people
    0:46:43 from getting treatment right now, stigma?
    0:46:45 – Also, with billions of dollars of opioid settlement money
    0:46:49 now flowing to states and cities,
    0:46:52 how is it going to be spent?
    0:46:54 – To use these monies to replace the status quo
    0:46:58 would be the largest travesty I could imagine
    0:47:01 from a financial perspective.
    0:47:03 And also from a victim’s rights perspective.
    0:47:06 – That’s next time on the show in the second part
    0:47:09 of our series about the continuing opioid epidemic.
    0:47:12 Until then, take care of yourself.
    0:47:14 And if you can, someone else too.
    0:47:17 Freakonomics Radio is produced by Stitcher and Renbud Radio.
    0:47:20 You can find our entire archive on any podcast app
    0:47:24 also at Freakonomics.com,
    0:47:26 where we publish transcripts and show notes.
    0:47:28 This episode was produced by Alina Coleman
    0:47:31 with help from Ryan Kelly.
    0:47:32 Our staff also includes Augusta Chapman, Dalvin Aboulagi,
    0:47:36 Eleanor Osborne, Elsa Hernandez, Gabriel Roth,
    0:47:39 Greg Rippon, Jasmine Klinger, Jeremy Johnston, Julie Canfer,
    0:47:42 Lyric Bowditch, Morgan Levy, Neil Carruth,
    0:47:44 Rebecca Lee Douglas, Sarah Lilly, Teo Jacobs,
    0:47:47 and Zach Lipinski.
    0:47:49 Our theme song is “Mr. Fortune” by the Hitchhikers
    0:47:52 and our composer is Louise Guerra.
    0:47:54 As always, thank you for listening.
    0:47:56 – If the criminal justice system were a parent
    0:48:05 and it wanted its child to clean up its room,
    0:48:08 it would say, “Johnny, if you don’t clean up your room,
    0:48:11 “there’s a 40% chance that six months from now
    0:48:13 “I will ground you for a decade.”
    0:48:20 – The Freakonomics Radio Network,
    0:48:22 the hidden side of everything.
    0:48:24 Stitcher.
    0:48:28 (gentle music)
    0:48:31 you

    Most epidemics flare up, do their damage, and fade away. This one has been raging for almost 30 years. To find out why, it’s time to ask some uncomfortable questions. (Part one of a two-part series.)

     

    • SOURCES:
      • David Cutler, professor of economics at Harvard University.
      • Travis Donahoe, professor of health policy and management at the University of Pittsburgh.
      • Keith Humphreys, professor of psychiatry and behavioral sciences at Stanford University.
      • Stephen Loyd, chief medical officer of Cedar Recovery and chair of the Tennessee Opioid Abatement Council.

     

     

  • Extra: Car Colors & Storage Units

    Presenting two stories from The Economics of Everyday Things: Why does it seem like every car is black, white, or gray these days? And: How self-storage took over America.

     

    • SOURCES:
      • Tom Crockett, classic car enthusiast.
      • Zachary Dickens, executive vice president and chief investment officer of Extra Space Storage.
      • Mark Gutjahr, global head of design at BASF.
      • Kara Kolodziej, self-storage unit tenant.
      • Anne Mari DeCoster, self-storage consultant.
      • Nikkie Riedel, carline planning manager at Subaru of America.

     

     

  • 588. Confessions of a Black Conservative

    The economist and social critic Glenn Loury has led a remarkably turbulent life, both professionally and personally. In a new memoir, he has chosen to reveal just about everything. Why?

     

    • SOURCE:
      • Glenn Loury, professor of economics at Brown University and host of The Glenn Show.

     

     

  • 587. Should Companies Be Owned by Their Workers?

    The employee ownership movement is growing, and one of its biggest champions is also a private equity heavyweight. Is this meaningful change, or just window dressing?

     

    • SOURCES:
      • Marjorie Kelly, distinguished senior fellow at The Democracy Collaborative.
      • Corey Rosen, founder and senior staff member of the National Center for Employee Ownership.
      • Pete Stavros, co-head of Global Private Equity at KKR.